Individual
JACK C FENG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
27871 MEDICAL CENTER RD, SUITE 200, MISSION VIEJO, CA 92691-6404
(949) 364-5090
(949) 542-8710
Mailing address
27871 MEDICAL CENTER RD STE 240, MISSION VIEJO, CA 92691-6406
(949) 364-5090
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
A64319
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A643190
—
CA
Enumeration date
12/23/2005
Last updated
10/28/2020
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