Provider Demographics
NPI:1093253999
Name:CHUNG, CURTIS (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:CURTIS
Middle Name:
Last Name:CHUNG
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:548 S SPRING ST
Mailing Address - Street 2:311
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90013-2307
Mailing Address - Country:US
Mailing Address - Phone:925-642-5522
Mailing Address - Fax:
Practice Address - Street 1:33 HILLCREST DR
Practice Address - Street 2:
Practice Address - City:ORINDA
Practice Address - State:CA
Practice Address - Zip Code:94563-3233
Practice Address - Country:US
Practice Address - Phone:925-642-5522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-10
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA292738225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist