Provider Demographics
NPI:1992152151
Name:CJ FRONTLINE, LLC
Entity type:Organization
Organization Name:CJ FRONTLINE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHLOE
Authorized Official - Middle Name:
Authorized Official - Last Name:YUK TING HEUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-521-6847
Mailing Address - Street 1:PO BOX 6029
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903-0029
Mailing Address - Country:US
Mailing Address - Phone:415-521-6847
Mailing Address - Fax:415-729-1691
Practice Address - Street 1:101 LUCAS VALLEY RD
Practice Address - Street 2:SUITE 236
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-1791
Practice Address - Country:US
Practice Address - Phone:415-521-6847
Practice Address - Fax:415-729-1691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-18
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health