Chung, Karlyssa Rae
Chung, Karlyssa Rae is an sole proprietor health care provider with primary practice located at 12556 Valley View St , Garden Grove CA 92845-2006. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Chung, Karlyssa Rae can be contacted via phone (714) 897-9355.Contact Information
Primary practice address
12556 Valley View St
Garden Grove CA 92845-2006
Phone: (714) 897-9355
Fax: (714) 897-5117
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | PA22611 | California |
Profile Details
| NPI number | 1518305168 |
|---|---|
| LBN Legal business name | Chung, Karlyssa Rae |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 5th, 2013 |
| Last updated | Mar 7th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1518305168 | NPPES |
| California | Other | PA22611 | MEDICAL LICENSE |
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