Chan-Pong, Kaseng Derek

Chan-Pong, Kaseng Derek is an individual health care provider with primary practice located at 1223 Gateway Dr Ste B , Melbourne FL 32901-2607. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Chan-Pong, Kaseng Derek can be contacted via phone (321) 725-4500.

Contact Information

Primary practice address
1223 Gateway Dr Ste B Melbourne FL 32901-2607
Phone: (321) 725-4500
Fax: (321) 952-2330
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X ME73216 Florida

Profile Details

NPI number 1316937535
LBN Legal business name Chan-Pong, Kaseng Derek
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 27th, 2005
Last updated Apr 4th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316937535 NPPES
Florida Other 49928Y MEDICARE
Florida MEDICAID 259780200 MEDICARE

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