Jin K Chung, ATC, CES

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

18400 Avalon Blvd
Ste 200
Carson, CA 90746-2172

Phone

(310) 738-3099

NPI assigned

Dec 24, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Pablo Chung Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1450915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450915200000",
    "number": "1538524145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18400 AVALON BLVD",
            "address_2": "STE 200",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907462172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18400 AVALON BLVD",
            "address_2": "STE 200",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907462172",
            "telephone_number": "310-738-3099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "JIN K",
        "credential": "ATC, CES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-12-24",
        "last_updated": "2015-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PABLO",
            "last_name": "CHUNG",
            "credential": "ATC, CES",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Athletic Trainer in Carson, CA
• Providers in Carson, CA by specialty
• Athletic Trainer in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.