MS. KARLYSSA RAE CHUNG (NPI# 1518305168) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518305168 |
| Entity Type | Individual |
| Full Name | MS. KARLYSSA RAE CHUNG |
| Credential | PA-C |
| Practice Address |
12556 Valley View St Garden Grove CA 92845-2006 |
| Practice Telephone | 7148979355 |
| Practice Fax Number | 7148975117 |
| Mailing Telephone | 7148979355 |
| Enumeration Date | 2013-06-05 |
| Last Update Date | 2016-02-26 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA22611 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDICAL LICENSE | PA22611 | 01 |
| CA | DEA | MW2753881 | 01 |
| Street Address |
12556 VALLEY VIEW ST |
| City | GARDEN GROVE |
| State | CA |
| Zip Code | 92845-2006 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194814020 | Michael Z Kurtz | Family Medicine | 12556 Valley View St, Garden Grove, CA 92845-2006 | 2006-10-11 |
| 1720267990 | Omid Avraham Shaye | Internal Medicine | 12556 Valley View St, Garden Grove, CA 92845-2006 | 2007-10-24 |
| 1184828659 | Kirsten Hope Fick | Physician Assistant | 12556 Valley View St, Garden Grove, CA 92845-2006 | 2007-06-11 |
| 1750434908 | Valley View Wellness Medical Center Inc | Family Medicine | 12556 Valley View St, Garden Grove, CA 92845-2006 | 2007-01-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962059352 | Maria Sanchez Selvas | Technician | 5922 Belgrave Ave, Garden Grove, CA 92845 | 2019-08-21 |
| 1205342524 | Ahcs Specialty Care LLC | Pharmacy | 12832 Valley View St Ste A&b, Garden Grove, CA 92845 | 2017-12-22 |
| 1154745594 | Amanda Siu | Dentist | 12062 Valley View St #250, Garden Grove, CA 92845 | 2014-02-05 |
| 1295085660 | Harrell M Reznick | Psychologist | 12792 Longden St, Garden Grove, CA 92845 | 2012-09-13 |
| 1093065328 | Jessica Eldridge | Psychologist | 12777 Valley View, Suite 212, Garden Grove, CA 92845 | 2012-09-13 |
| 1205114501 | Hideki Ikeda D.d.s., M.s., Dental Corporation | Dentist | 12777 Valley View St.., Suite 222, Garden Grove, CA 92845 | 2011-08-03 |
| 1669652533 | David D. Brown | Psychiatry & Neurology | 12062 Valley View St Ste 107, Garden Grove, CA 92845 | 2007-11-08 |
| 1427267608 | Stacy Derenard | Speech-Language Pathologist | 12060 Valley View St, Suite 137, Garden Grove, CA 92845 | 2007-05-22 |
| 1992914170 | Erin Dawn Densmore | Speech-Language Pathologist | 12060 Valley View St., Suite 137, Garden Grove, CA 92845 | 2007-05-22 |
| 1902944929 | Regency Hospice Inc | Hospice Care, Community Based | 12062 Valley View Street #125, Garden Grove, CA 92845 | 2007-02-02 |
| Find all providers in zip 92845 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982162863 | Robert Vu Cao | Physician Assistant | 10707 Lauren Cir, Garden Grove, CA 92840-5012 | 2019-03-09 |
| 1740219930 | Sharon Liekhus | Physician Assistant | 7052 Orangewood Ave Ste 6, Garden Grove, CA 92841-1419 | 2006-07-01 |
| 1629481312 | Pacorpnation | Physician Assistant | 12665 Garden Grove Blvd Ste 713, Garden Grove, CA 92843-1921 | 2014-06-10 |
| 1417210204 | Tuan Manh Le | Physician Assistant | 9191 Westminster Ave, Garden Grove, CA 92844-2751 | 2012-06-18 |
| 1295047413 | William U Galdamez | Physician Assistant | 12601 Garden Grove Blvd, Garden Grove, CA 92843-1908 | 2010-07-02 |
| 1821164880 | Van Hoang Nguyen | Physician Assistant | 12555 Garden Grove Blvd, Suite 206, Garden Grove, CA 92843-1902 | 2006-11-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760089437 | Karine Harutyunyan | Physician Assistant | 500 E Colorado St Ste 101, Glendale, CA 91205-1607 | 2020-10-06 |
| 1437756228 | Kale Burket | Physician Assistant | Bldg 523, S 8th St, El Centro, CA 92243 | 2020-10-05 |
| 1548867666 | Heba Marzouk Al-shoubaki | Physician Assistant | 633 S Pepper St, Anaheim, CA 92802-1459 | 2020-10-01 |
| 1275140550 | Lisa Lynn Passalacqua | Physician Assistant | 431 7th St, Norco, CA 92860-1671 | 2020-09-30 |
| 1144833989 | Trisha Taylor | Physician Assistant | 10399 Tivoli Way, Yucaipa, CA 92399-6017 | 2020-08-30 |
| 1457963944 | Harlan William Monahan | Physician Assistant | 5210 Del Rio Rd, Sacramento, CA 95822-2519 | 2020-08-18 |
| 1275144313 | Sofia Carmen Bustillo | Physician Assistant | 1709 Coral Pl, Seal Beach, CA 90740-5712 | 2020-08-12 |
| 1124638663 | Gayaneh Gharakhani | Physician Assistant | 1323 E Broadway Apt 110, Glendale, CA 91205-4018 | 2020-08-07 |
| 1144830183 | Loc Bao Tran | Physician Assistant | 8937 Emerson Pl, Rosemead, CA 91770-2813 | 2020-08-04 |
| 1558997957 | Sarah Lubinsky | Physician Assistant | 1511 Montana Ave, Santa Monica, CA 90403-1891 | 2020-03-17 |
| Find all providers with the same taxonomy | ||||
| City | GARDEN GROVE |
| Zip Code | 92845 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.