Provider Demographics
NPI:1316022569
Name:CHUNG, ROBERT SUNG (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:SUNG
Last Name:CHUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ROBERT
Other - Middle Name:SUNG
Other - Last Name:CHUNG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:13121 SHAWNEE LN
Mailing Address - Street 2:SUITE 269B
Mailing Address - City:SEAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90740-7211
Mailing Address - Country:US
Mailing Address - Phone:714-594-8719
Mailing Address - Fax:714-534-3352
Practice Address - Street 1:11039 ACACIA PKWY
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92840-5126
Practice Address - Country:US
Practice Address - Phone:714-594-8719
Practice Address - Fax:714-534-3352
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2009-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA26228146D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant