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General NPI Number Information
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NPI Number | 1639326796
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Entity Type | Individual
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Provider Name | CHRISTINA JUNG M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/20/2008
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Last Update Date | 05/05/2014
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Provider Practice Location Address
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Address Line | 12011 LEE JACKSON MEMORIAL HWY STE 220
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City | FAIRFAX
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State | VA
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Zip | 22033-3310
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Country | US
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Telephone | 703-865-5437
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Fax |
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Provider Business Mailing Address
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Address Line | 4467 MONMOUTH ST
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City | FAIRFAX
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State | VA
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Zip | 22030-6185
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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 |
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 0101246094
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License Number State | VA
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