Active NPI
Paul Vincent Chiong
- Registered Nurse
- Fontana, CA
National Provider Identifier
1235776972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 803515
- Practice address
- 17053 Foothill Blvd BLDG B
Fontana, CA 92335-3574 - Phone
- (909) 347-1300
- NPI assigned
- Dec 2, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 803515 | CA | Primary |
Addresses
Primary practice location
17053 Foothill Blvd BLDG B
Fontana, CA 92335-3574
Mailing address
67905 Paletero Rd
Cathedral City, CA 92234-5583
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 803515 | CA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1575244800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1575244800000",
"number": "1235776972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "67905 PALETERO RD",
"city": "CATHEDRAL CITY",
"state": "CA",
"postal_code": "922345583"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17053 FOOTHILL BLVD BLDG B",
"city": "FONTANA",
"state": "CA",
"postal_code": "923353574",
"telephone_number": "909-347-1300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHIONG",
"first_name": "PAUL VINCENT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-12-02",
"last_updated": "2019-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "803515",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fontana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.