Healthcare Provider Details

I. General information

NPI: 1336636828
Provider Name (Legal Business Name): NATALIE NARIE CHUNG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2018
Last Update Date: 08/16/2023
Certification Date: 08/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

622 ABBOTT ST
SALINAS CA
93901-4315
US

IV. Provider business mailing address

63 S ROCKFORD DR STE 220
TEMPE AZ
85288-6226
US

V. Phone/Fax

Practice location:
  • Phone: 831-771-3900
  • Fax: 831-424-7835
Mailing address:
  • Phone: 831-771-3900
  • Fax: 831-424-7835

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number125072110
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberA177366
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: