Provider Demographics
NPI:1649224999
Name:JUNG, JAMES K (DPM)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:K
Last Name:JUNG
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1045 ATLANTIC AVE
Mailing Address - Street 2:SUITE 807
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90813-3408
Mailing Address - Country:US
Mailing Address - Phone:562-437-3338
Mailing Address - Fax:562-437-1919
Practice Address - Street 1:1045 ATLANTIC AVE
Practice Address - Street 2:SUITE 807
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90813-3408
Practice Address - Country:US
Practice Address - Phone:562-437-3338
Practice Address - Fax:562-437-1919
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAE4130213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E41300Medicaid
CA000E41300Medicaid
CA5731410001Medicare NSC
CAE4130Medicare PIN