Provider Demographics
NPI:1528195518
Name:CHUNG, AI-KYUNG (CRNA)
Entity Type:Individual
Prefix:MS
First Name:AI-KYUNG
Middle Name:
Last Name:CHUNG
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 POTRERO AVE # 3C38
Mailing Address - Street 2:SFGH ANESTHESIA
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-3518
Mailing Address - Country:US
Mailing Address - Phone:415-206-8213
Mailing Address - Fax:415-206-6014
Practice Address - Street 1:1001 POTRERO AVE # 3C38
Practice Address - Street 2:SFGH ANESTHESIA
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-3518
Practice Address - Country:US
Practice Address - Phone:415-206-8213
Practice Address - Fax:415-206-6014
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN398128163WM0705X
CACRNA2139367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
Not Answered367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
033357OtherSFGH INTERNAL USE ONLY-COMMERCIAL NUMBER