Individual
DIANE CHUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
540 S CIRCULO LAZO, ANAHEIM, CA 92807-4302
(714) 222-0558
Mailing address
540 S CIRCULO LAZO, ANAHEIM, CA 92807-4302
(714) 222-0558
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95009401
CA
Other
Enumeration date
09/08/2018
Last updated
09/08/2018
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