Healthcare Provider Details

I. General information

NPI: 1629349170
Provider Name (Legal Business Name): EUNA CHUNG, M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2012
Last Update Date: 01/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25550 HAWTHORNE BLVD SUITE 210
TORRANCE CA
90505-6825
US

IV. Provider business mailing address

25550 HAWTHORNE BLVD SUITE 210
TORRANCE CA
90505-6825
US

V. Phone/Fax

Practice location:
  • Phone: 310-294-9002
  • Fax:
Mailing address:
  • Phone: 310-294-9002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA89830
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberA89830
License Number StateCA

VIII. Authorized Official

Name: DR. EUNA CHUNG
Title or Position: PSYCHIATRIST
Credential: MD
Phone: 310-294-9002