Active NPI
Edmund Chong, MD
- Otolaryngology Physician
- Oakland, CA
National Provider Identifier
1730267899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- G45507
- Practice address
- 275 W Macarthur
Oakland, CA 94611-5641 - Phone
- (510) 752-1000
- NPI assigned
- Nov 2, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | G45507 | CA | Primary |
Addresses
Primary practice location
275 W Macarthur
Oakland, CA 94611-5641
Mailing address
275 W Macarthur
Oakland, CA 94611-5641
Phone (510) 752-1000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G455070 | Medicaid | CA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G45507 | CA | MD | Otolaryngology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410825600000",
"number": "1730267899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "275 W MACARTHUR",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946115641",
"telephone_number": "510-752-1000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "275 W MACARTHUR",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946115641",
"telephone_number": "510-752-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHONG",
"first_name": "EDMUND",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-02",
"last_updated": "2014-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "CA",
"license": "G45507",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G455070",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.