Individual
DR. DEREK S MONGOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3400 DELTA FAIR BLVD, ANTIOCH, CA 94509-4004
(925) 777-6399
Mailing address
3400 DELTA FAIR BLVD, ANTIOCH, CA 94509-4004
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0101251845
VA
207Q00000X
Family Medicine Physician
22903
WV
207Q00000X
Family Medicine Physician
A122589
CA
2084P0800X
Psychiatry Physician
0101251845
VA
2084P0800X
Psychiatry Physician
22903
WV
2084P0800X
Psychiatry Physician
Primary
A122589
CA
Other
Enumeration date
05/08/2007
Last updated
12/15/2021
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