Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | MD09323 | OR |
NPI | 1629057997 |
---|---|
Provider Name | Dr. C. John Chunn |
First Address | Bend, OR 97701 |
Second Address | Bend, OR 97701 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/01/2006 |
Last Update Date | 06/04/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
048827 | (05) | OR |
C92399 | (02) |