Provider Demographics
NPI:1093943375
Name:CHUNG, NANCY C (MD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:C
Last Name:CHUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:407 W IMPERIAL HWY
Mailing Address - Street 2:H-171
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-4832
Mailing Address - Country:US
Mailing Address - Phone:562-365-3540
Mailing Address - Fax:714-990-2754
Practice Address - Street 1:407 W IMPERIAL HWY
Practice Address - Street 2:H-171
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-4832
Practice Address - Country:US
Practice Address - Phone:562-365-3540
Practice Address - Fax:714-990-2754
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-25
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA61456208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics