Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | A99992 | CA |
N | 208600000X | Surgeon | A99992 | CA |
Y | 2086S0102X | Surgical Critical Care | A99992 | CA |
NPI | 1003021882 |
---|---|
Provider Name | Dr. Rex Tong Hyun Chung |
First Address | Loma Linda, CA 92354-3060 |
Second Address | Loma Linda, CA 92350-1700 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2007 |
Last Update Date | 23/03/2016 |