| J. Chung, D.d.s., Inc. | |
|
3250 W Olympic Blvd Ste 208 Los Angeles CA 90006-2367 | |
| (323) 766-1004 | |
| Not Available |
| Full Name | J. Chung, D.d.s., Inc. |
|---|---|
| Speciality | Dentist |
| Location | 3250 W Olympic Blvd, Los Angeles, California |
| Authorized Official Name and Position | Joo Sung Chung (PRESIDENT) |
| Authorized Official Contact | 3237661004 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| J. Chung, D.d.s., Inc. 3250 W Olympic Blvd Ste 208 Los Angeles CA 90006-2367 Ph: (323) 766-1004 | J. Chung, D.d.s., Inc. 3250 W Olympic Blvd Ste 208 Los Angeles CA 90006-2367 Ph: (323) 766-1004 |
| NPI Number | 1679964456 |
|---|---|
| Provider Enumeration Date | 02/14/2015 |
| Last Update Date | 02/14/2015 |
| Medicare PECOS PAC ID | 8729306444 |
|---|---|
| Medicare Enrollment ID | O20150409000703 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679964456 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0700X | Dentist - Prosthodontics | 45444 (California) | Primary |
| Provider Name | Joo Sung Chung |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1821243551 PECOS PAC ID: 9638497357 Enrollment ID: I20150409000820 |
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