Healthcare Provider Details

I. General information

NPI: 1962908855
Provider Name (Legal Business Name): ESTHER H CHUNG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2018
Last Update Date: 06/01/2023
Certification Date: 06/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1195 W FREMONT AVE
SUNNYVALE CA
94087-3832
US

IV. Provider business mailing address

1195 W FREMONT AVE
SUNNYVALE CA
94087-3832
US

V. Phone/Fax

Practice location:
  • Phone: 919-684-8111
  • Fax:
Mailing address:
  • Phone: 650-498-7911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number178480
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: