Provider Demographics
NPI:1891723946
Name:CHUNG, HSING HSIANG (MD)
Entity Type:Individual
Prefix:DR
First Name:HSING
Middle Name:HSIANG
Last Name:CHUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:HENRY
Other - Middle Name:HSING
Other - Last Name:CHUNG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1801 W ROMNEYA DR
Mailing Address - Street 2:SUITE 501
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-1830
Mailing Address - Country:US
Mailing Address - Phone:714-991-6130
Mailing Address - Fax:714-991-6103
Practice Address - Street 1:1801 W ROMNEYA DR
Practice Address - Street 2:SUITE 501
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-1830
Practice Address - Country:US
Practice Address - Phone:714-991-6130
Practice Address - Fax:714-991-6103
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-29
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA36097174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A360970Medicaid
CAA36097Medicare PIN
CAD14145Medicare UPIN
CA1891723946Medicare NSC