Provider Demographics
NPI:1093174435
Name:HYUN, CHELSEA (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHELSEA
Middle Name:
Last Name:HYUN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1551 UNION ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-3437
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4305 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92105-1645
Practice Address - Country:US
Practice Address - Phone:619-501-1235
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-13
Last Update Date:2016-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program