Healthcare Provider Details

I. General information

NPI: 1376971358
Provider Name (Legal Business Name): CHRISTINA UNG FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2013
Last Update Date: 06/24/2024
Certification Date: 06/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1421 E 17TH ST
SANTA ANA CA
92705-8505
US

IV. Provider business mailing address

801 E KATELLA AVE
ANAHEIM CA
92805-6614
US

V. Phone/Fax

Practice location:
  • Phone: 714-633-6373
  • Fax:
Mailing address:
  • Phone: 714-633-6373
  • Fax: 714-633-1443

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95000389
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: