Active NPI
Mimi Chung, ACSW
- Social Worker
- Commerce, CA
National Provider Identifier
1740312834
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 20148
- Practice address
- 1000 Goodrich Blvd
Commerce, CA 90022-5103 - Phone
- (323) 832-9795
- NPI assigned
- Mar 12, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 20148 | CA | Primary |
Addresses
Primary practice location
1000 Goodrich Blvd
Commerce, CA 90022-5103
Mailing address
433 Kelton Ave Apt 113
Los Angeles, CA 90024-2029
Phone (323) 578-2617
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ENK1858 | Other | CA | LA DEPT MENTAL HEALTH |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20148 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1740312834",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "433 KELTON AVE APT 113",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900242029",
"telephone_number": "323-578-2617"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 GOODRICH BLVD",
"city": "COMMERCE",
"state": "CA",
"postal_code": "900225103",
"telephone_number": "323-832-9795"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHUNG",
"first_name": "MIMI",
"name_prefix": "Miss",
"credential": "ACSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "20148",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LA DEPT MENTAL HEALTH",
"identifier": "ENK1858",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Commerce, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.