Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 151934 | MA |
NPI | 1295706596 |
---|---|
Provider Name | Dr. James J Chun |
First Address | San Diego, CA 92134-1098 |
Second Address | San Diego, CA 92134-1098 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
151934 | MEDICAL LICENSE NUMBER (01) | MA |