Provider Demographics
NPI:1366585028
Name:CHUNG, HUNGSUN SONG (OD)
Entity type:Individual
Prefix:DR
First Name:HUNGSUN
Middle Name:SONG
Last Name:CHUNG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14345 SARATOGA AVE
Mailing Address - Street 2:APT 36
Mailing Address - City:SARATOGA
Mailing Address - State:CA
Mailing Address - Zip Code:95070-5944
Mailing Address - Country:US
Mailing Address - Phone:408-857-1942
Mailing Address - Fax:
Practice Address - Street 1:2908 EL CAMINO REAL STE 120
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-2944
Practice Address - Country:US
Practice Address - Phone:408-984-2020
Practice Address - Fax:408-984-2016
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10919T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist