Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | NP 17479 | CA |
NPI | 1003066556 |
---|---|
Provider Name | Woosin Chung |
First Address | Pasadena, CA 91105-2603 |
Second Address | Pasadena, CA 91105-2626 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2008 |
Last Update Date | 27/10/2021 |