Provider Demographics
NPI:1821032939
Name:JEU, HELEN CHONG (MD)
Entity type:Individual
Prefix:
First Name:HELEN
Middle Name:CHONG
Last Name:JEU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22526 CANYON LAKE DR S
Mailing Address - Street 2:
Mailing Address - City:CANYON LAKE
Mailing Address - State:CA
Mailing Address - Zip Code:92587-7559
Mailing Address - Country:US
Mailing Address - Phone:951-765-5417
Mailing Address - Fax:
Practice Address - Street 1:235 LAURSEN STREET
Practice Address - Street 2:HEMET RADIOLOGY MEDICAL GROUP, INC.
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543
Practice Address - Country:US
Practice Address - Phone:951-765-5417
Practice Address - Fax:951-765-5418
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2010-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC382542085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA300048953OtherRAILROAD
CA00C382540Medicaid
CA300091183OtherRAILROAD
CACW634YOtherMEDICARE PTAN - HVI
CACW634ZOtherMEDICARE PTAN
CA00C382540Medicaid
CA00C382545Medicare PIN