Basic Information
| Provider Information | |||||||||
| NPI: | 1609887371 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHUNG | ||||||||
| FirstName: | YUEH-JU | ||||||||
| MiddleName: | YALE | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2410 SAMARITAN DR | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | SAN JOSE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 951243909 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4083710390 | ||||||||
| FaxNumber: | 4083710462 | ||||||||
| Practice Location | |||||||||
| Address1: | 2410 SAMARITAN DR | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | SAN JOSE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 951243909 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4083710728 | ||||||||
| FaxNumber: | 4083711164 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | A75583 | CA | X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085R0204X | A75583 | CA | X | Allopathic & Osteopathic Physicians | Radiology | Vascular & Interventional Radiology |
No ID Information.