Provider Demographics
NPI:1477561504
Name:CHUNG, JOYCE W (MD)
Entity Type:Individual
Prefix:DR
First Name:JOYCE
Middle Name:W
Last Name:CHUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10670 WEXFORD ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-3940
Mailing Address - Country:US
Mailing Address - Phone:858-621-4090
Mailing Address - Fax:858-621-4082
Practice Address - Street 1:10670 WEXFORD ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131-3940
Practice Address - Country:US
Practice Address - Phone:858-621-4090
Practice Address - Fax:858-621-4082
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA50122207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A501220Medicaid
CAWA50122AMedicare ID - Type Unspecified
CA00A501220Medicaid