Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | A36508B | CA |
NPI | 1023106143 |
---|---|
Provider Name | Byung Wha Chun |
First Address | Anaheim, CA 92804 |
Second Address | Anaheim, CA 92804-3702 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 03/11/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A28109 | (02) |