Organization
SOOMCHUNGMDONCOLOGY-HEMATOLOGYPC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SOO MARN CHUNG M.D. (CEO)
(714) 539-6414
Entity
Organization
Contact information
Practice address
12555 GARDEN GROVE BLVD STE 309, GARDEN GROVE, CA 92843-1903
(714) 539-6414
(714) 539-6933
Mailing address
12555 GARDEN GROVE BLVD STE 309, GARDEN GROVE, CA 92843-1903
(714) 539-6414
(714) 539-6933
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A41090
CA
207RH0003X
Hematology & Oncology Physician
Primary
A41090
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A410900
—
CA
01
—
05D0675453
CLIA
CA
Enumeration date
02/12/2008
Last updated
02/12/2008
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