Healthcare Provider Details

I. General information

NPI: 1912291188
Provider Name (Legal Business Name): CATHERINE B CHUNG M D INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2011
Last Update Date: 09/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 BARRANCA PKWY STE 130
IRVINE CA
92606-8227
US

IV. Provider business mailing address

210 N TUSTIN AVE
SANTA ANA CA
92705-3807
US

V. Phone/Fax

Practice location:
  • Phone: 949-552-6266
  • Fax: 949-552-5038
Mailing address:
  • Phone: 714-347-1010
  • Fax: 714-647-1245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberG77777
License Number StateCA

VIII. Authorized Official

Name: DR. CATHERINE BIK-WAI CHUNG
Title or Position: PRESIDENT
Credential: MD
Phone: 800-883-7243