1407937725 NPI number — DR. EDWIN H CHUN DC

Table of content: DR. EDWIN H CHUN DC (NPI 1407937725)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407937725 NPI number — DR. EDWIN H CHUN DC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHUN
Provider First Name:
EDWIN
Provider Middle Name:
H
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1407937725
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/15/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1281 N DIAMOND BAR BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DIAMOND BAR
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91765-1151
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
323-702-4348
Provider Business Mailing Address Fax Number:
909-861-0952

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6503 GREENLEAF AVE STE D
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WHITTIER
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90601-4138
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-702-4348
Provider Business Practice Location Address Fax Number:
909-861-0952
Provider Enumeration Date:
10/17/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  DC25677 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)