Provider Demographics
NPI:1427089002
Name:CHUNG, DANNY K (MD)
Entity type:Individual
Prefix:
First Name:DANNY
Middle Name:K
Last Name:CHUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2420 ABADEJO, LA VERNE,CA 91750
Mailing Address - Street 2:201 W GARVEY AVE., # 108
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-7418
Mailing Address - Country:US
Mailing Address - Phone:626-573-2188
Mailing Address - Fax:626-573-1345
Practice Address - Street 1:2420 ABADEJO, LA VERNE,CA 91750
Practice Address - Street 2:201 W GARVEY AVE., # 108
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-7418
Practice Address - Country:US
Practice Address - Phone:626-573-2188
Practice Address - Fax:626-573-1345
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAC 38984208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC 38984Medicare ID - Type Unspecified