Provider Demographics
NPI:1962581892
Name:HUNG, HIN-CHIU (MD)
Entity type:Individual
Prefix:
First Name:HIN-CHIU
Middle Name:
Last Name:HUNG
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 1:625 W COLLEGE ST
Mailing Address - Street 2:106
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-1650
Mailing Address - Country:US
Mailing Address - Phone:213-620-8730
Mailing Address - Fax:213-620-9522
Practice Address - Street 1:625 W COLLEGE ST
Practice Address - Street 2:106
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-1650
Practice Address - Country:US
Practice Address - Phone:213-620-8730
Practice Address - Fax:213-620-9522
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA37041207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A370410Medicaid
CAA84954Medicare UPIN
CA00A370410Medicaid