| Eastfield Ming Quong | |
|
209 Lemos Ave Santa Cruz CA 95060-5114 | |
| (831) 421-9918 | |
| Not Available |
| Full Name | Eastfield Ming Quong |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 209 Lemos Ave, Santa Cruz, California |
| Authorized Official Name and Position | Kelli Williamson (CLINICAL PROGRAM MANAGER) |
| Authorized Official Contact | 4088320832 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastfield Ming Quong 209 Lemos Ave Santa Cruz CA 95060-5114 Ph: (831) 421-9918 | Eastfield Ming Quong 209 Lemos Ave Santa Cruz CA 95060-5114 Ph: (831) 421-9918 |
| NPI Number | 1093881112 |
|---|---|
| Provider Enumeration Date | 11/28/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093881112 | NPI | - | NPPES |
| A5480825 | Other | CA | DRIVER'S LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 20903 (California) | Primary |
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