MEDICARE: DR. LINDA HANNA CHUNG M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207LP3000X	Pediatric Anesthesiology Physician	A127592	CA
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1417190596
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LINDA HANNA CHUNG M.D.

Provider Business Mailing Address
First Line	:	3003 WOODSIDE MEADOWS RD
Second Line	:
City	:	PLEASANT HILL
State	:	CA
Zip	:	94523-3187
Country	:	US
Telephone Number	:	217-390-3268
Fax Number	:

Provider Business Practice Location Address
First Line	:	718 UNIVERSITY AVE STE 211
Second Line	:
City	:	LOS GATOS
State	:	CA
Zip	:	95032-7608
Country	:	US
Telephone Number	:	408-354-2114
Fax Number	:	408-354-0633

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2009
Last Update Date	:	03/20/2015

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