Basic Information
| Provider Information | |||||||||
| NPI: | 1427125814 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DORJEE | ||||||||
| FirstName: | KUNCHOK | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX AD | ||||||||
| Address2: | AMPLA HEALTH PROVIDER CREDENTIALING | ||||||||
| City: | YUBA CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 959921396 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5307513769 | ||||||||
| FaxNumber: | 5307511237 | ||||||||
| Practice Location | |||||||||
| Address1: | 680 COHASSET RD | ||||||||
| Address2: | |||||||||
| City: | CHICO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 959262213 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5303424395 | ||||||||
| FaxNumber: | 5309842325 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/29/2006 | ||||||||
| LastUpdateDate: | 06/13/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | A62939 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.