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General NPI Number Information
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NPI Number | 1215724596
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Entity Type | Organization
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Legal Business Name | SAE HWAN CHUNG DDS INC
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Dates
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Enumeration Date | 04/22/2025
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Last Update Date | 04/22/2025
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Provider Practice Location Address
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Address Line | 34488 YUCAIPA BLVD STE F
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City | YUCAIPA
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State | CA
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Zip | 92399-2482
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Country | US
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Telephone | 909-797-0303
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Fax |
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Provider Business Mailing Address
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Address Line | 25519 CARROL CT
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City | LOMA LINDA
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State | CA
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Zip | 92354-3700
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. SAE HWAN CHUNG
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Credential | DDS
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Telephone | 909-953-5142
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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