Individual
CAROL CHUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
10945 LE CONTE AVE, 2339, LOS ANGELES, CA 90095-3000
(310) 825-6301
Mailing address
393 E WALNUT ST FL 3, PHR GROUP PROVIDER ENROLLMENT UNIT, PASADENA, CA 91188-0001
(877) 608-0044
(877) 514-0903
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20A 1032B
CA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
05/29/2008
Last updated
12/02/2021
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