Provider Demographics
NPI:1003811969
Name:CHAE, JUN HO (MD)
Entity Type:Individual
Prefix:DR
First Name:JUN HO
Middle Name:
Last Name:CHAE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 WILLARD
Mailing Address - Street 2:KAISER PERMANENTE BARRANCA MEDICAL OFFICE
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-4694
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6 WILLARD
Practice Address - Street 2:KAISER PERMANENTE BARRANCA MEDICAL OFFICE
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-4694
Practice Address - Country:US
Practice Address - Phone:949-262-5755
Practice Address - Fax:949-262-5774
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-16
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2005-0303207Q00000X
CAA102920207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine