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Individual

MICHELLE K CHUNG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AGACNP-BC

Contact information

Practice address
757 WESTWOOD PLZ, LOS ANGELES, CA 90095-2895
(310) 206-8232
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
776729
CA
363LA2100X
Acute Care Nurse Practitioner
Primary
95013343
CA
363LG0600X
Gerontology Nurse Practitioner
95013343
CA

Other

Enumeration date
12/06/2019
Last updated
02/08/2022
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