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NPI Code Detail

MEDICARE: ELLIE YU-RIM CHUNG DDS

MEDICARE:   ELLIE YU-RIM CHUNG  DDS
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
11223G0001XGeneral Practice Dentistry112589CA

General Provider Information

NPI Number : 1669315412
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELLIE YU-RIM CHUNG DDS
Provider Business Mailing Address
First Line : 2242 ROOT ST
Second Line :
City : FULLERTON
State : CA
Zip : 92833-2107
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2118 S HACIENDA BLVD
Second Line :
City : HACIENDA HEIGHTS
State : CA
Zip : 91745-4242
Country : US
Telephone Number : 626-369-9998
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2026
Last Update Date : 04/14/2026

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Directions to “ ELLIE YU-RIM CHUNG DDS” Practice Location

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