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Michelle K Chung

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

757 Westwood Plz, Los Angeles, CA 90095-2895

PECOS Enrollment

This provider is enrolled in PECOS as MICHELLE CHUNG.

Based on the most recent information from CMS, provider Michelle K Chung is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 11 days ago.

Profile Details

Provider ID
1538706783
Provider Type
Individual
Full Name
Chung, Michelle K
Credential
AGACNP-BC

Gender
Female
Sole Proprietor
No
Enumeration Date
12/6/2019
Last Updated
2/8/2022

Contact Information

Practice Location

757 Westwood Plz, Los Angeles, CA 90095-2895

(310) 206-8232

Unlisted Fax

Mailing Location

5767 W Century Blvd Ste 400, Los Angeles, CA 90045-5631

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LA2100X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 95013343 California
Code 163W00000X	Description Registered Nurse Nursing Service Providers	License 776729 California
Code 363LG0600X	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 95013343 California

Michelle K Chung

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

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