Mary S Jung MD Inc

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

A73312 Issued in CA

Legal business name

MARY S JUNG MD INC

Practice address

1506 E Chapman Ave
Orange, CA 92866-2231

Phone

(714) 538-8556

Fax

(714) 538-1082

NPI assigned

Sep 13, 2006

Last updated

Jul 31, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mary Sun Jung, M.D.NPI 1821032871

Title

President

Phone

(714) 538-8556

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mary S Jung, M.D.

  • Dermatology Physician
  • Orange, CA
  • NPI 1821032871
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406764800000",
    "number": "1265537765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1506 E CHAPMAN AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928662231",
            "telephone_number": "714-538-8556",
            "fax_number": "714-538-1082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1506 E CHAPMAN AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928662231",
            "telephone_number": "714-538-8556",
            "fax_number": "714-538-1082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY S JUNG MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2014-07-31",
        "status": "A",
        "authorized_official_last_name": "JUNG",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "SUN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-538-8556",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A73312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A733120",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "05D1058795",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "A73312",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Ontiveros Martins
• Gregory George Maruki, L.AC
• Amir Hossein Alim Marvasti
• Marwaha and Marwah Medical Corporation
• Mary a Cote, MD
• Miriam Mas Otiniano
• Elysha I Maselli
• Brian Scott Maser, MD
• Kayla Mashoudy, MD
• Dania Mason

• Dermatology Physician in Orange, CA
• Providers in Orange, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2014; 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.