Provider Demographics
NPI:1447367966
Name:CHUNG, HANKYU (MD)
Entity type:Individual
Prefix:DR
First Name:HANKYU
Middle Name:
Last Name:CHUNG
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 1:2039 FOREST AVE
Mailing Address - Street 2:SUITE 303
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-4817
Mailing Address - Country:US
Mailing Address - Phone:408-297-8600
Mailing Address - Fax:408-297-5643
Practice Address - Street 1:2039 FOREST AVE
Practice Address - Street 2:SUITE 303
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-4817
Practice Address - Country:US
Practice Address - Phone:408-297-8600
Practice Address - Fax:408-297-5643
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA31980207RC0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
00A319801Medicare PIN
CAA26663Medicare UPIN