Provider Demographics
NPI:1609835545
Name:YOUNHO CHUNG
Entity Type:Organization
Organization Name:YOUNHO CHUNG
Other - Org Name:JOHN R YOUNG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN EMPLOYEE
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:R
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-969-6060
Mailing Address - Street 1:719 CAPITAL AVE SW
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-5023
Mailing Address - Country:US
Mailing Address - Phone:269-969-6060
Mailing Address - Fax:269-965-7710
Practice Address - Street 1:719 CAPITAL AVE SW
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-5023
Practice Address - Country:US
Practice Address - Phone:269-969-6060
Practice Address - Fax:269-965-7710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
371301315OtherSS