Individual
BENJAMIN CHUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4500 BROCKTON AVE, SUITE 306, RIVERSIDE, CA 92501-4090
(951) 321-0100
(951) 321-0131
Mailing address
420 N MCKINLEY ST, 111-616, CORONA, CA 92879-6504
(951) 321-0100
(951) 321-0131
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G70147
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G701470
—
CA
Enumeration date
08/30/2005
Last updated
11/09/2011
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