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NPI Code Detail

MEDICARE: MARK A. CHUNG, O.D., A PROFESSIONAL CORPORATION

MEDICARE: MARK A. CHUNG, O.D., A PROFESSIONAL CORPORATION
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
1152W00000XOptometrist

General Provider Information

NPI Number : 1861800997
Entity Type Code : Organization
Provider Name (Legal Business Name) : MARK A. CHUNG, O.D., A PROFESSIONAL CORPORATION
Provider Business Mailing Address
First Line : 8205 SANTA MONICA BLVD
Second Line : SUITE 15
City : WEST HOLLYWOOD
State : CA
Zip : 90046-5977
Country : US
Telephone Number : 323-650-0337
Fax Number : 323-650-7783
Provider Business Practice Location Address
First Line : 8205 SANTA MONICA BLVD
Second Line : SUITE 15
City : WEST HOLLYWOOD
State : CA
Zip : 90046-5977
Country : US
Telephone Number : 323-650-0337
Fax Number : 323-650-7783
Authorized Official
Title or Position : OWNER, PRESIDENT
Name : DR. MARK ALLEN CHUNG
Credential : O.D.
Telephone Number : 323-650-0337
Provider Enumeration Date : 08/01/2014
Last Update Date : 08/01/2014

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Directions to “MARK A. CHUNG, O.D., A PROFESSIONAL CORPORATION ” Practice Location

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