Provider Demographics
NPI:1245233139
Name:CHUN, SHELLEY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SHELLEY
Middle Name:
Last Name:CHUN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11629 WINDCREST LN
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-4276
Mailing Address - Country:US
Mailing Address - Phone:760-586-3979
Mailing Address - Fax:
Practice Address - Street 1:10680 TREENA ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131-2444
Practice Address - Country:US
Practice Address - Phone:858-790-6642
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51514183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist