Healthcare Provider Details

I. General information

NPI: 1033096003
Provider Name (Legal Business Name): CRYSTAL KIT-YING CHUNG PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2025
Last Update Date: 08/20/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4250 FIRST AVENUE
SAN DIEGO CA
92103
US

IV. Provider business mailing address

182 VERNON ST
SAN FRANCISCO CA
94132-3041
US

V. Phone/Fax

Practice location:
  • Phone: 619-471-0238
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number89002
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: