Provider Demographics
NPI:1609887371
Name:CHUNG, YUEH-JU YALE (MD)
Entity Type:Individual
Prefix:
First Name:YUEH-JU
Middle Name:YALE
Last Name:CHUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2410 SAMARITAN DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124-3909
Mailing Address - Country:US
Mailing Address - Phone:408-371-0390
Mailing Address - Fax:408-371-0462
Practice Address - Street 1:2410 SAMARITAN DR
Practice Address - Street 2:SUITE 102
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-3909
Practice Address - Country:US
Practice Address - Phone:408-371-0728
Practice Address - Fax:408-371-1164
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA755832085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Not Answered2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A755830Medicare ID - Type Unspecified
I39500Medicare UPIN