Organization
LA JOLLA FACIAL PLASTIC SURGERY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VICTOR CHUNG M.D. (PRESIDENT/DIRECTOR)
(858) 461-0383
Entity
Organization
Contact information
Practice address
4765 CARMEL MOUNTAIN RD, SUITE 103, SAN DIEGO, CA 92130-6657
(858) 461-0383
(858) 430-2772
Mailing address
4765 CARMEL MOUNTAIN RD, SUITE 103, SAN DIEGO, CA 92130-6657
(858) 461-0383
(858) 430-2772
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
A136426
CA
Other
Enumeration date
09/14/2015
Last updated
02/21/2017
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