Healthcare Provider Details

I. General information

NPI: 1457265761
Provider Name (Legal Business Name): HYUNJIN CHUNG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1819 W REDLANDS BLVD STE 101
REDLANDS CA
92373-3121
US

IV. Provider business mailing address

10927 SUNNY COVE CT
REDLANDS CA
92373-4251
US

V. Phone/Fax

Practice location:
  • Phone: 909-335-5400
  • Fax:
Mailing address:
  • Phone: 909-312-8010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number91932
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: