Healthcare Provider Details

I. General information

NPI: 1528195518
Provider Name (Legal Business Name): AI-KYUNG CHUNG CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 POTRERO AVE # 3C38 SFGH ANESTHESIA
SAN FRANCISCO CA
94110-3518
US

IV. Provider business mailing address

1001 POTRERO AVE # 3C38 SFGH ANESTHESIA
SAN FRANCISCO CA
94110-3518
US

V. Phone/Fax

Practice location:
  • Phone: 415-206-8213
  • Fax: 415-206-6014
Mailing address:
  • Phone: 415-206-8213
  • Fax: 415-206-6014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License NumberRN398128
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberCRNA2139
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: