Individual provider · NPI-1

Dr. Brent Gong, D.C.

Chiropractor · Madera, CA

NPI number1912054255
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1912054255
Entity type
Individual (NPI-1)
Name
Dr. Brent Gong
Credential
D.C.
Sex
Male
Sole proprietor
Yes
Enumeration date
Jan 5, 2007
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
111N00000X Chiropractor22254CAYes

Practice location

1929 Howard Rd
Madera, CA 93637-5134

Phone 559-673-8888

Mailing address

1929 Howard Rd
Madera, CA 93637-5134

Phone 559-673-8888

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