Individual provider Active NPI

Eric Chung

  • Hand Occupational Therapist
  • Costa Mesa, CA
National Provider Identifier
1629490883
Registry record updated May 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
15876 Issued in CA
Practice address
1700 Adams Ave
#103
Costa Mesa, CA 92626-4865
Phone
(714) 556-2288
NPI assigned
Jan 7, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational Therapist 225XH1200X 15876 CA Primary

Addresses

Primary practice location

1700 Adams Ave
#103
Costa Mesa, CA 92626-4865

Mailing address

4455 Casa Grande Cir
#120
Cypress, CA 90630-2556
Phone (714) 321-8222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15876CAMDHand Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hands on Hands Rehabilitation Center, Inc. PastSince May 10, 2016 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: eric.chung.p29@direct.newportmed.nextgenshare.com
  • Direct secure messaging: eric.chung.p46@direct.newportmed.nextgenshare.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1389052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462147200000",
    "number": "1629490883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4455 CASA GRANDE CIR",
            "address_2": "#120",
            "city": "CYPRESS",
            "state": "CA",
            "postal_code": "906302556",
            "telephone_number": "714-321-8222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 ADAMS AVE",
            "address_2": "#103",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926264865",
            "telephone_number": "714-556-2288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "ERIC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-01-07",
        "last_updated": "2016-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "CA",
            "license": "15876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2016; 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.