Individual
BEVERLY JONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2120 COWELL BLVD, DAVIS, CA 95618-7835
(216) 644-0074
Mailing address
PO BOX 252, DAVIS, CA 95617-0252
(216) 644-0074
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
136770
CA
Other
Enumeration date
06/10/2009
Last updated
10/06/2015
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