Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | C28231 | CA |
NPI | 1003818055 |
---|---|
Provider Name | Richard B. D. Chun |
First Address | Roseville, CA 95661-4548 |
Second Address | Roseville, CA 95661-4103 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2005 |
Last Update Date | 12/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00C282310 | (05) | CA |
00C282310 | BLUE SHIELD (01) | CA |
952587937 | BLUE CROSS (01) | CA |
C28231 | BLUE CROSS (01) | CA |
E33595 | (02) | CA |