Provider Demographics
NPI:1417190596
Name:CHUNG, LINDA HANNA (MD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:HANNA
Last Name:CHUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LINDA
Other - Middle Name:HANNA
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3003 WOODSIDE MEADOWS RD
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-3187
Mailing Address - Country:US
Mailing Address - Phone:217-390-3268
Mailing Address - Fax:
Practice Address - Street 1:718 UNIVERSITY AVE STE 211
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-7608
Practice Address - Country:US
Practice Address - Phone:408-354-2114
Practice Address - Fax:408-354-0633
Is Sole Proprietor?:No
Enumeration Date:2009-04-20
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA127592207LP3000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program