Provider Demographics
NPI:1932477148
Name:CHUNG, HYUN (OTD, OTR/L)
Entity Type:Individual
Prefix:MS
First Name:HYUN
Middle Name:
Last Name:CHUNG
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1180 CORNWELL DR
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92833-5759
Mailing Address - Country:US
Mailing Address - Phone:714-222-0711
Mailing Address - Fax:
Practice Address - Street 1:1180 CORNWELL DR
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92833-5759
Practice Address - Country:US
Practice Address - Phone:714-222-0711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-02
Last Update Date:2023-03-08
Deactivation Date:2022-07-27
Deactivation Code:
Reactivation Date:2023-03-08
Provider Licenses
StateLicense IDTaxonomies
CAOT7337225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist