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General NPI Number Information
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NPI Number | 1881039824
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Entity Type | Individual
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Provider Name | JENNA CHUNG D.O.
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Gender | Female
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Dates
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Enumeration Date | 05/03/2013
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Last Update Date | 12/17/2021
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Provider Practice Location Address
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Address Line | 200 MUIR RD BLDG FLOOR2
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City | MARTINEZ
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State | CA
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Zip | 94553-4614
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Country | US
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Telephone | 925-372-1999
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Fax | 925-372-1871
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Provider Business Mailing Address
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Address Line | 200 MUIR RD BLDG FLOOR2
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City | MARTINEZ
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State | CA
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Zip | 94553-4614
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Country | US
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Telephone | 925-372-1999
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Fax | 925-372-1871
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 283139
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20A15223
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License Number State | CA
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