Healthcare Provider Details

I. General information

NPI: 1932234929
Provider Name (Legal Business Name): JEFFREY CHAN YUNG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 11/25/2024
Certification Date: 11/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 SUTTER ST STE 304
SAN FRANCISCO CA
94115-3029
US

IV. Provider business mailing address

2300 SUTTER ST STE 304
SAN FRANCISCO CA
94115-3029
US

V. Phone/Fax

Practice location:
  • Phone: 415-563-2233
  • Fax: 415-212-7114
Mailing address:
  • Phone: 415-563-2233
  • Fax: 415-212-7114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberA69799
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberA69799
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: