Active NPI
Chin W Chung, MD
- Urology Physician
- Laguna Niguel, CA
National Provider Identifier
1891702718
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- C129000
- Practice address
- 24891 Stonegate LN
Laguna Niguel, CA 92677-8809 - Phone
- (917) 415-7656
- NPI assigned
- Aug 2, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Urology Physician | 208800000X | C129000 | CA | Primary |
Addresses
Primary practice location
24891 Stonegate LN
Laguna Niguel, CA 92677-8809
Mailing address
24891 Stonegate LN
Laguna Niguel, CA 92677-8809
Phone (917) 415-7656
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00775484 | Medicaid | NY |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C129000 | CA | MD | Urology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732665600000",
"number": "1891702718",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24891 STONEGATE LN",
"city": "LAGUNA NIGUEL",
"state": "CA",
"postal_code": "926778809",
"telephone_number": "917-415-7656"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24891 STONEGATE LN",
"city": "LAGUNA NIGUEL",
"state": "CA",
"postal_code": "926778809",
"telephone_number": "917-415-7656"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHUNG",
"first_name": "CHIN",
"middle_name": "W",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-02",
"last_updated": "2024-11-27",
"certification_date": "2024-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "CA",
"license": "C129000",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00775484",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Laguna Niguel, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.