Provider Demographics
NPI:1639178270
Name:CHUNG, CHONG HEE (DC)
Entity Type:Individual
Prefix:
First Name:CHONG
Middle Name:HEE
Last Name:CHUNG
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:
Other - Last Name:CHUNG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:4600 BEACH BLVD STE G
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-1166
Mailing Address - Country:US
Mailing Address - Phone:714-736-5456
Mailing Address - Fax:714-736-5461
Practice Address - Street 1:4600 BEACH BLVD STE G
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90621-1166
Practice Address - Country:US
Practice Address - Phone:714-736-5456
Practice Address - Fax:714-736-5461
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC25420111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor