Organization
JONG C MOON MD INC
Active
Other names
SHAFTER RURAL HEALTH CARE
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONG CHUN MOON M.D. (ADMINISTRATOR)
(661) 746-5788
Entity
Organization
Contact information
Practice address
406 JAMES ST, SHAFTER, CA 93263-2035
(661) 746-5788
(661) 746-5273
Mailing address
406 JAMES ST, SHAFTER, CA 93263-2035
(661) 746-5788
(661) 746-5273
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
A356070
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RHM53818F
—
CA
Enumeration date
04/19/2007
Last updated
06/25/2012
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