Peter J. Chung, M.D. Inc.

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

A121679 Issued in CA

Legal business name

PETER J. CHUNG, M.D. INC.

Practice address

266 S Harvard Blvd
Suite 340
Los Angeles, CA 90004-4372

Phone

(786) 877-4558

NPI assigned

Aug 30, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Peter J Chung, M.D.NPI 1104056845

Title

President

Phone

(213) 908-5014

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Peter Jeano Chung, MD

  • Cardiovascular Disease Physician
  • Los Angeles, CA
  • NPI 1104056845
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1472515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565654400000",
    "number": "1174079040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "266 S HARVARD BLVD",
            "address_2": "SUITE 340",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900044372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "266 S HARVARD BLVD",
            "address_2": "SUITE 340",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900044372",
            "telephone_number": "786-877-4558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER J. CHUNG, M.D. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-30",
        "last_updated": "2019-08-13",
        "status": "A",
        "authorized_official_last_name": "CHUNG",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "213-908-5014",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A121679",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A121679",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CA",
            "license": "A121679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA STATE LICENSE",
            "identifier": "A121679",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Interventional Cardiology Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Interventional Cardiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.