Individual
MS. KARLYSSA RAE CHUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
12556 VALLEY VIEW ST, GARDEN GROVE, CA 92845-2006
(714) 897-9355
(714) 897-5117
Mailing address
12556 VALLEY VIEW ST, GARDEN GROVE, CA 92845-2006
(714) 897-9355
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA22611
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA22611
MEDICAL LICENSE
CA
Enumeration date
06/05/2013
Last updated
03/07/2023
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