Provider Demographics
NPI:1992847065
Name:CHUNG, CHRISTOPHER YOUNGKWON (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:YOUNGKWON
Last Name:CHUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2815 S MAIN ST
Mailing Address - Street 2:SUITE #110
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-2531
Mailing Address - Country:US
Mailing Address - Phone:951-278-8385
Mailing Address - Fax:951-278-2930
Practice Address - Street 1:2815 S MAIN ST
Practice Address - Street 2:SUITE #110
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-2531
Practice Address - Country:US
Practice Address - Phone:951-278-8385
Practice Address - Fax:951-278-2930
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA 55450208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery