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NPI Code Detail

MEDICARE: DANIEL CHUNG M.D.

MEDICARE: DANIEL CHUNG M.D.
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
1207Q00000XFamily Medicine Physician29727AZ

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1031815OTHERAZMEDICARE
2031813OTHERAZMEDICARE
3031820OTHERAZMEDICARE
4031814OTHERAZMEDICARE
5ZFQ31815OTHERMEDICARE

General Provider Information

NPI Number : 1821091984
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIEL CHUNG M.D.
Provider Business Mailing Address
First Line : PO BOX 10097
Second Line :
City : CASA GRANDE
State : AZ
Zip : 85130-0020
Country : US
Telephone Number : 520-836-3446
Fax Number : 520-836-8807
Provider Business Practice Location Address
First Line : 865 N ARIZOLA RD
Second Line :
City : CASA GRANDE
State : AZ
Zip : 85122-6011
Country : US
Telephone Number : 520-836-3446
Fax Number : 520-836-8807
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2005
Last Update Date : 04/18/2011

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Directions to “ DANIEL CHUNG M.D.” Practice Location

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