Provider Demographics
NPI:1487970737
Name:CHUNG, ALICE FAITH YUO (MD)
Entity type:Individual
Prefix:DR
First Name:ALICE
Middle Name:FAITH YUO
Last Name:CHUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:ALICE
Other - Middle Name:FAITH
Other - Last Name:YUO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3723 W 12600 S
Mailing Address - Street 2:SUITE 270A
Mailing Address - City:RIVERTON
Mailing Address - State:UT
Mailing Address - Zip Code:84065-7295
Mailing Address - Country:US
Mailing Address - Phone:801-285-4620
Mailing Address - Fax:801-285-4699
Practice Address - Street 1:3723 W 12600 S
Practice Address - Street 2:SUITE 270A
Practice Address - City:RIVERTON
Practice Address - State:UT
Practice Address - Zip Code:84065-7295
Practice Address - Country:US
Practice Address - Phone:801-285-4620
Practice Address - Fax:801-285-4699
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-12
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8138565-1205208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery