Provider Demographics
NPI:1669641940
Name:NORTH COUNTY WOMENS MEDICAL CLINIC,INC
Entity Type:Organization
Organization Name:NORTH COUNTY WOMENS MEDICAL CLINIC,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:YUNG
Authorized Official - Last Name:KUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-761-4088
Mailing Address - Street 1:120 CRAVEN RD.
Mailing Address - Street 2:SUITE 209
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92078-4237
Mailing Address - Country:US
Mailing Address - Phone:760-761-4088
Mailing Address - Fax:760-761-4090
Practice Address - Street 1:120 CRAVEN RD
Practice Address - Street 2:SUITE 209
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-4235
Practice Address - Country:US
Practice Address - Phone:760-761-4088
Practice Address - Fax:760-761-4090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-21
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG40829207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty