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General NPI Number Information
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NPI Number | 1194818518
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Entity Type | Individual
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Provider Name | JAMES CHUNG O.D.
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Gender | Male
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Dates
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Enumeration Date | 09/30/2006
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Last Update Date | 08/23/2023
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Provider Practice Location Address
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Address Line | 720 E VALLEY BLVD
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City | SAN GABRIEL
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State | CA
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Zip | 91776-3547
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Country | US
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Telephone | 626-288-8097
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Fax | 626-288-8031
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Provider Business Mailing Address
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Address Line | 20442 MILANO CT
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City | YORBA LINDA
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State | CA
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Zip | 92886-8623
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Country | US
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Telephone | 626-315-7522
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 11494T
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License Number State | CA
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