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NPI Code Detail

MEDICARE: DR. MATTHEW WAYNE JUNG MD

MEDICARE: DR. MATTHEW WAYNE JUNG 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
1207R00000XInternal Medicine PhysicianA124125CA

General Provider Information

NPI Number : 1588970115
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MATTHEW WAYNE JUNG MD
Provider Business Mailing Address
First Line : 12414 EXPOSITION BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90064-1016
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 12414 EXPOSITION BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90064-1016
Country : US
Telephone Number : 310-272-7640
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2010
Last Update Date : 07/30/2025

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Directions to “ DR. MATTHEW WAYNE JUNG MD” Practice Location

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