Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 40756 | CA |
NPI | 1003247313 |
---|---|
Provider Name | Taryn Chun |
First Address | Emeryville, CA 94608-1062 |
Second Address | Emeryville, CA 94608-1062 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2013 |
Last Update Date | 12/12/2013 |