Individual
DR. JIMMY Y. CHUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
907 GEORGIANA ST, PORT ANGELES, WA 98362-3911
(360) 565-0999
Mailing address
907 GEORGIANA ST, PORT ANGELES, WA 98362-3911
(360) 565-0999
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
A70974
CA
208600000X
Surgery Physician
Primary
MD00037817
WA
2086S0129X
Vascular Surgery Physician
A70974
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A70974
CA MEDICAL LICENSE
CA
05
—
GR0100250
—
CA
01
—
MD00037817
WA MEDICAL LICENSE
WA
Enumeration date
11/06/2006
Last updated
12/30/2018
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