Healthcare Provider Details

I. General information

NPI: 1851928816
Provider Name (Legal Business Name): EVAN CHUNG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2020
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25333 BARTON RD
LOMA LINDA CA
92350-0210
US

IV. Provider business mailing address

24430 LAWTON AVE
LOMA LINDA CA
92354-3342
US

V. Phone/Fax

Practice location:
  • Phone: 909-825-8601
  • Fax:
Mailing address:
  • Phone: 949-988-9034
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberA196337
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: