Provider Demographics
NPI:1073875753
Name:CHUNG, REBECCA SUEYOUNG (MD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:SUEYOUNG
Last Name:CHUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24785 STEWART ST
Mailing Address - Street 2:EVANS HALL SUITE 204
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92350
Mailing Address - Country:US
Mailing Address - Phone:909-651-5809
Mailing Address - Fax:
Practice Address - Street 1:24785 STEWART ST EVANS HL STE 204
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92350-2804
Practice Address - Country:US
Practice Address - Phone:909-651-5809
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1302432083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine