Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | A63887 | CA |
NPI | 1003881889 |
---|---|
Provider Name | Dr. Philip W Chung |
First Address | Torrance, CA 90505-5004 |
Second Address | Torrance, CA 90505-5111 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2006 |
Last Update Date | 28/02/2018 |