Healthcare Provider Details

I. General information

NPI: 1144469826
Provider Name (Legal Business Name): CHAN Y CHUNG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/19/2009
Last Update Date: 03/13/2024
Certification Date: 03/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 MEDICAL CENTER DR SUITE 1660 TVC
NASHVILLE TN
37232-5280
US

IV. Provider business mailing address

1301 MEDICAL CENTER DR SUITE 1660 TVC
NASHVILLE TN
37232-5280
US

V. Phone/Fax

Practice location:
  • Phone: 615-322-3373
  • Fax: 615-322-8525
Mailing address:
  • Phone: 615-322-3373
  • Fax: 615-322-8525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0008X
TaxonomyHepatology Physician
License NumberA108087
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: