Provider Demographics
NPI:1720534720
Name:MEDEX HEALTH CENTER
Entity Type:Organization
Organization Name:MEDEX HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO / PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JUN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIONG
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MPH
Authorized Official - Phone:909-809-0289
Mailing Address - Street 1:1605 VALLE DEL SOL
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373
Mailing Address - Country:US
Mailing Address - Phone:909-809-0289
Mailing Address - Fax:
Practice Address - Street 1:1600 N ARROWHEAD AVE
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92405-4640
Practice Address - Country:US
Practice Address - Phone:909-809-0289
Practice Address - Fax:855-233-7921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-30
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health