Basic Information
Provider Information
NPI: 1427026442
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHUNG
FirstName: LORINDA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1000 WELCH RD
Address2: SUITE 203
City: PALO ALTO
State: CA
PostalCode: 943041811
CountryCode: US
TelephoneNumber:  
FaxNumber: 6507239656
Practice Location
Address1: 3801 MIRANDA AVE
Address2: PALO ALTO VA HOSPITAL
City: PALO ALTO
State: CA
PostalCode: 943041207
CountryCode: US
TelephoneNumber: 6504935000
FaxNumber: 6508491213
Other Information
ProviderEnumerationDate: 03/08/2006
LastUpdateDate: 06/10/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XA76014CAN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RR0500XA76014CAY Allopathic & Osteopathic PhysiciansInternal MedicineRheumatology

No ID Information.


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