Bo Chung, MD
Individual provider Active NPI Family Medicine Physician · Fallon, NV
NPI 1285892158 · NPPES record last updated Dec 22, 2021
Key facts
- NPI
- 1285892158
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 14008 (NV)
- Practice address
- 801 E Williams Ave
Fallon, NV 89406-3052 - Phone
- (213) 999-0326
- NPI assigned
- May 28, 2008
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Permanente Medical Group Inc
Practice addresses (Care Compare)
7373 W Lane
Stockton, CA 95210-3377
Phone (209) 476-2000
Hospital & facility affiliations
- Kaiser Foundation Hosp So Sacramento
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160628000238 | CA | Practitioner - Family Practice | 5496925679 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Permanente Medical Group, Inc | Current |
Accepting new patients | |
| Permanente Medical Group Inc | Family Medicine | Current | Accepting new patients |
| Permanente Medical Group Inc | Family Medicine | Current |
Accepting new patients |
| Center for Interventional Spine, a Medical Corporation | Past | Accepting new patients |
Locations
750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131
10305 Promenade Pkwy
Elk Grove, CA 95757
Phone (916) 478-5000
4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738
900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014
101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109
1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015
901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500
930 W Main St
Ripon, CA 95366
Phone (209) 599-4221
2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000
710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400
7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000
975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000
320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 14008 | NV | Yes |
Addresses
Primary practice location
801 E Williams Ave
Fallon, NV 89406-3052
Mailing address
801 E Williams Ave
Fallon, NV 89406-3052
Phone (213) 999-0326
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) | The Permanente Medical Group |
Other providers in Fallon, NV
- Central Nevada Vision Inc
- Christopher Chai
- Tiara Cheatham
- Kerry Susan Chicoine
- Kasey Chu
- Churchill Council on Alcohol & Other Drugs
- Churchill Council on Alcohol & Other Drugs
- Churchill County
- Churchill County School District
- Churchill Mangat Emergency Group PC
All providers in Fallon, NV · Family Medicine Physician in Nevada
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 22, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.