| Chinatown Christian Medical Group | |
|
711 W College St Ste 530 Los Angeles CA 90012-1163 | |
| (213) 617-2923 | |
| (213) 226-5469 |
| Full Name | Chinatown Christian Medical Group |
|---|---|
| Speciality | General Practice |
| Location | 711 W College St, Los Angeles, California |
| Authorized Official Name and Position | Yiu Ting Chung (PRESIDENT) |
| Authorized Official Contact | 2136172923 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chinatown Christian Medical Group 711 W College St Ste 530 Los Angeles CA 90012-1163 Ph: (213) 617-2923 | Chinatown Christian Medical Group 711 W College St Ste 530 Los Angeles CA 90012-1163 Ph: (213) 617-2923 |
| NPI Number | 1538173083 |
|---|---|
| Provider Enumeration Date | 07/28/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 4183807670 |
|---|---|
| Medicare Enrollment ID | O20110321000802 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538173083 | NPI | - | NPPES |
| 00G565300 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | FNP 13764 (California) | Primary |
| Provider Name | Yiu Ting Chung |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1851311583 PECOS PAC ID: 5092998583 Enrollment ID: I20110321000828 |
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