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General NPI Number Information
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NPI Number | 1831323039
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Entity Type | Individual
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Provider Name | JUN MO CHUNG M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/04/2009
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 15TH MDG 755 SCOTT CIRCLE
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City | JBPH-HICKAM
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State | HI
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Zip | 96853
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Country | US
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Telephone | 808-448-6377
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Fax |
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Provider Business Mailing Address
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Address Line | PSC 3 BOX 8394
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City | APO
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State | AP
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Zip | 96266-0084
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 2011001611
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | RESIDENT
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License Number State | MO
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