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NPI Code Detail

MEDICARE: DR. HYUN-SUK CHONG MD

MEDICARE: DR. HYUN-SUK CHONG MD
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
1207RE0101XEndocrinology, Diabetes & Metabolism Physician32903AZ

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00167538OTHERAZRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3860911876OTHERAZTAX ID#
4AZ0761080OTHERAZBCBS

General Provider Information

NPI Number : 1558354100
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HYUN-SUK CHONG MD
Provider Business Mailing Address
First Line : 15640 N 28TH DR
Second Line :
City : PHOENIX
State : AZ
Zip : 85053-4059
Country : US
Telephone Number : 602-439-9000
Fax Number : 602-978-5233
Provider Business Practice Location Address
First Line : 15640 N 28TH DR
Second Line :
City : PHOENIX
State : AZ
Zip : 85053-4059
Country : US
Telephone Number : 602-439-9000
Fax Number : 602-978-5233
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2005
Last Update Date : 08/30/2016

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Directions to “ DR. HYUN-SUK CHONG MD” Practice Location

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