Provider Demographics
NPI:1770621260
Name:HUNG, WARREN CHILUN (MD)
Entity type:Individual
Prefix:
First Name:WARREN
Middle Name:CHILUN
Last Name:HUNG
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 1:14 GALENA
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92602
Mailing Address - Country:US
Mailing Address - Phone:714-730-8998
Mailing Address - Fax:
Practice Address - Street 1:14150 CULVER DRIVE
Practice Address - Street 2:SUITE 306
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604
Practice Address - Country:US
Practice Address - Phone:949-559-1496
Practice Address - Fax:949-559-1492
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA55808207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A558080Medicaid
CAA55808Medicare ID - Type Unspecified
G78464Medicare UPIN