Jong C Moon MD Inc

Organization Active NPI Rural Health Clinic/Center · Shafter, CA

NPI 1457578403 · NPPES record last updated Jun 25, 2012

Key facts

NPI
1457578403
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
License
A356070 (CA)
Legal business name
JONG C MOON MD INC
Practice address
406 James St
Shafter, CA 93263-2035
Phone
(661) 746-5788
Fax
(661) 746-5273
NPI assigned
Apr 19, 2007
Organization subpart
No

Authorized official

Name
Dr. Jong Chun Moon, M.D.
Title
Administrator
Phone
(661) 746-5788

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X A356070 CA Yes

Addresses

Primary practice location

406 James St
Shafter, CA 93263-2035

Mailing address

406 James St
Shafter, CA 93263-2035
Phone (661) 746-5788

Other identifiers

IdentifierTypeStateIssuer
RHM53818FMedicaidCA

Other names

  • SHAFTER RURAL HEALTH CARE Other name

Other providers in Shafter, CA

All providers in Shafter, CA · Rural Health Clinic/Center in California

Sources for this page

Verify at the official NPI Registry.