MEDICARE: BETSY P CHUNG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225C00000X	Rehabilitation Counselor
2	103T00000X	Psychologist	PSY26045	CA

General Provider Information

NPI Number	:	1093964876
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETSY P CHUNG

Provider Business Mailing Address
First Line	:	4425 JAMBOREE RD
Second Line	:	SUITE 183
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-3024
Country	:	US
Telephone Number	:	626-872-3156
Fax Number	:

Provider Business Practice Location Address
First Line	:	4425 JAMBOREE RD
Second Line	:	SUITE 183
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-3024
Country	:	US
Telephone Number	:	626-872-3156
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2008
Last Update Date	:	12/12/2016

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Directions to “ BETSY P CHUNG ” Practice Location

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