Physician Compare National (NPI:1013147099)

HEALTHCARE PROVIDER: GAR WIN CHUNG D.O.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1013147099
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8729242631
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120605000640
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CHUNG
	Individual professional last name
Provider First Name	GAR
	Individual professional first name
Provider Middle Name	W
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2009
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	9300 W SUNSET RD
	Group Practice or individual's line 1 address
City	LAS VEGAS
	Group Practice or individual's city
State	NV
	Group Practice or individual's state
Zip Code	891484844
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	290053
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST ROSE DOMINICAN HOSPITALS - SAN MARTIN CAMPUS
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	290047
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y