Healthcare Provider Details

I. General information

NPI: 1326569419
Provider Name (Legal Business Name): ANGELA CHUNG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2017
Last Update Date: 12/30/2024
Certification Date: 10/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5581 ALTON PKWY
IRVINE CA
92618-4056
US

IV. Provider business mailing address

5581 ALTON PKWY
IRVINE CA
92618-4056
US

V. Phone/Fax

Practice location:
  • Phone: 949-453-4308
  • Fax: 949-453-4328
Mailing address:
  • Phone: 949-453-4308
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA164413
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: