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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RHM53818F | Medicaid | CA |
Other names
- SHAFTER RURAL HEALTH CARE
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- Joel N Cooper Physical Therapist Inc.
- Rowena S Jones
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- Uzma Khan
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- Michael L. Komin
- Anthony Minh Le
All providers in Shafter, CA · Rural Health Clinic/Center in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 25, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.