Individual
DANIEL CHUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
865 N ARIZOLA RD, CASA GRANDE, AZ 85122-6011
(520) 836-3446
(520) 836-8807
Mailing address
PO BOX 10097, CASA GRANDE, AZ 85130-0020
(520) 836-3446
(520) 836-8807
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
29727
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
031813
MEDICARE
AZ
01
—
031814
MEDICARE
AZ
01
—
031815
MEDICARE
AZ
01
—
031820
MEDICARE
AZ
01
—
ZFQ31815
MEDICARE
—
Enumeration date
05/23/2005
Last updated
04/18/2011
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