Individual
DR. ILSONG JASON CHONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
605 CROUCH ST BLDG C, OCEANSIDE, CA 92054-4415
(760) 736-6767
(760) 736-8740
Mailing address
605 CROUCH ST BLDG C, OCEANSIDE, CA 92054-4415
(760) 736-6767
(760) 736-8740
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
C152937
CA
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
K4025
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0089HL
BLUECROSS BLUESHIELD
TX
05
—
047274802
—
TX
Enumeration date
01/15/2007
Last updated
03/17/2018
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