Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | OMS25 | CA |
NPI | 1013008598 |
---|---|
Provider Name | Dr. Alan Patrick Chun |
First Address | San Ramon, CA 94583-3960 |
Second Address | San Ramon, CA 94583-3960 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H18240 | (02) | CA |