Provider Demographics
NPI:1154551042
Name:CHUNG, VICTOR (MD)
Entity type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:
Last Name:CHUNG
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Gender:M
Credentials:MD
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Mailing Address - Street 1:4765 CARMEL MOUNTAIN RD
Mailing Address - Street 2:STE 103
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-6657
Mailing Address - Country:US
Mailing Address - Phone:858-461-0383
Mailing Address - Fax:858-430-2772
Practice Address - Street 1:4765 CARMEL MOUNTAIN RD
Practice Address - Street 2:STE 103
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-6657
Practice Address - Country:US
Practice Address - Phone:858-461-0383
Practice Address - Fax:858-430-2772
Is Sole Proprietor?:No
Enumeration Date:2009-07-25
Last Update Date:2017-01-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA136426207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery