Provider Demographics
NPI:1376507152
Name:CHUNG YEUNG, DOROTHY (DPT)
Entity Type:Individual
Prefix:MS
First Name:DOROTHY
Middle Name:
Last Name:CHUNG YEUNG
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:728 PACIFIC AVE
Mailing Address - Street 2:STE 301
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94133-4457
Mailing Address - Country:US
Mailing Address - Phone:415-433-3318
Mailing Address - Fax:415-433-3538
Practice Address - Street 1:728 PACIFIC AVE
Practice Address - Street 2:STE 301
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94133-4457
Practice Address - Country:US
Practice Address - Phone:415-433-3318
Practice Address - Fax:415-433-3538
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14973225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA14973OtherPT BOARD OF CA LICENSE
CAPT0149730OtherMEDI-CAL PROVIDER NUMBER
CA00PT59901Medicare ID - Type Unspecified
CAPT0149730OtherMEDI-CAL PROVIDER NUMBER