Provider Demographics
NPI:1225126311
Name:TSI, CHUNG H (MD)
Entity Type:Individual
Prefix:
First Name:CHUNG
Middle Name:H
Last Name:TSI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90813-3402
Mailing Address - Country:US
Mailing Address - Phone:562-491-9292
Mailing Address - Fax:562-495-1878
Practice Address - Street 1:1025 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90813-3402
Practice Address - Country:US
Practice Address - Phone:562-491-9292
Practice Address - Fax:562-495-1878
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA451820208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA9113916Medicare UPIN