Provider Demographics
NPI:1053623306
Name:CHUNG, YU-TING JULIE (OD)
Entity type:Individual
Prefix:DR
First Name:YU-TING
Middle Name:JULIE
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 1:43091 OLD GALLIVAN TER
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-7437
Mailing Address - Country:US
Mailing Address - Phone:571-217-1376
Mailing Address - Fax:
Practice Address - Street 1:19360 COMPASS CREEK PKWY
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20175-5445
Practice Address - Country:US
Practice Address - Phone:571-258-4644
Practice Address - Fax:571-248-4643
Is Sole Proprietor?:No
Enumeration Date:2010-07-01
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001955152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist