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General NPI Number Information
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NPI Number | 1992847065
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Entity Type | Individual
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Provider Name | CHRISTOPHER YOUNGKWON CHUNG M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 11/13/2012
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Provider Practice Location Address
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Address Line | 2815 S MAIN ST SUITE #110
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City | CORONA
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State | CA
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Zip | 92882-2531
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Country | US
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Telephone | 951-278-8385
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Fax | 951-278-2930
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Provider Business Mailing Address
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Address Line | 2815 S MAIN ST SUITE #110
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City | CORONA
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State | CA
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Zip | 92882-2531
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Country | US
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Telephone | 951-278-8385
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Fax | 951-278-2930
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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 | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | A 55450
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License Number State | CA
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