Provider Demographics
NPI:1639312937
Name:CHUNG, HUNG (MD)
Entity Type:Individual
Prefix:
First Name:HUNG
Middle Name:
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 1:14807 HARMONY LN
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-5852
Mailing Address - Country:US
Mailing Address - Phone:225-939-2592
Mailing Address - Fax:
Practice Address - Street 1:15606 BROOKHURST ST
Practice Address - Street 2:SUITE B
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-7581
Practice Address - Country:US
Practice Address - Phone:714-531-0000
Practice Address - Fax:714-531-1006
Is Sole Proprietor?:No
Enumeration Date:2009-04-16
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA131729207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine