Derek Patrick Gong in Santa Rosa - Pediatrics
Derek Patrick Gong - NPI 1184671513
Derek Patrick Gong is a Pediatrics in Santa Rosa, California. Derek Patrick Gong practices all healthcare services and medical treatments related to Pediatrics. The NPI Number for Derek Patrick Gong is 1184671513. The last update date is 2007-11-28.
Derek Patrick Gong's current location address is 16319 Third Street, Santa Rosa, California. You can contact this provider via phone number 7078692849 and fax number 7078691477. The mailing address for Derek Patrick Gong is 16319 Third Street, Santa Rosa, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Derek Patrick Gong |
|---|---|
| Address | 16319 Third Street, Santa Rosa, California |
| Phone Number | 7078692849 |
| Fax Number | 7078691477 |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1184671513 |
|---|---|
| Provider Enumeration Date | 2006-05-30 |
| Last Updated Date | 2007-11-28 |
Provider Mailing Address Detail
| Address | 16319 Third Street |
|---|---|
| City | Santa Rosa |
| State | California (CA) |
| Post Code | 95446 |
| Phone Number | 7078692849 |
| Fax Number | 7078691477 |
Provider's Primary Taxonomy Detail
| Speciality | Pediatrics |
|---|---|
| Taxonomy | 208000000X |
| Licence No | A66344 |
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Definition: A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 00A663440 | CA | -- | |
| ZZZ73222Z | CA | GROUP PTAN | |
| FHC03887F | CA | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Derek Patrick Gong by the Centers for Medicare & Medicaid Services (CMS)?
The Derek Patrick Gong has been assigned the NPI (National Provider Identifier) 1184671513. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you please share the complete physical location address where Derek Patrick Gong's facilities are situated?
The facilities of Derek Patrick Gong are physically located at the following address: 16319 Third Street, Santa Rosa, CA, 95446.
What is the Derek Patrick Gong's specialty and taxonomy code?
The Derek Patrick Gong's specialty is Pediatrics, and the corresponding taxonomy code is 208000000X.
On what date did Derek Patrick Gong receive its 1184671513 assignment from the Centers for Medicare & Medicaid Services?
The Derek Patrick Gong was assigned its 1184671513 on 2006-05-30, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the information regarding Derek Patrick Gong most recently updated?
The details pertaining to the Derek Patrick Gong, including its address, specialty, and other relevant information, were last refreshed on 2007-11-28.