Healthcare Provider Details

I. General information

NPI: 1093149908
Provider Name (Legal Business Name): CHELSEA CHUNG DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2013
Last Update Date: 12/17/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 E ROMIE LN
SALINAS CA
93901-4029
US

IV. Provider business mailing address

100 WILSON RD SUITE 100
MONTEREY CA
93940-7885
US

V. Phone/Fax

Practice location:
  • Phone: 831-759-3257
  • Fax: 831-754-3875
Mailing address:
  • Phone: 831-649-1000
  • Fax: 831-649-4961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A13670
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: