Organization
LAVINIA K. CHONG, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAVINIA KAREN CHONG M.D. (CHIEF MEDICAL OFFICER)
(949) 644-1400
Entity
Organization
Contact information
Practice address
1401 AVOCADO AVE, SUITE 803, NEWPORT BEACH, CA 92660-7720
(949) 644-1400
(949) 644-5988
Mailing address
1401 AVOCADO AVE, SUITE 803, NEWPORT BEACH, CA 92660-7720
(949) 644-1400
(949) 644-5988
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
G68371
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1588779227
MEDICARE (INDIVIDUAL) NPI
CA
01
—
G68371
PTAN
CA
Enumeration date
06/22/2012
Last updated
06/22/2012
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