Provider Demographics
NPI:1508441478
Name:SC CHUN MD, PC
Entity Type:Organization
Organization Name:SC CHUN MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SOO
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-516-0779
Mailing Address - Street 1:PO BOX 576649
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95357-6649
Mailing Address - Country:US
Mailing Address - Phone:209-845-2553
Mailing Address - Fax:
Practice Address - Street 1:1878 E HATCH RD
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95351-5096
Practice Address - Country:US
Practice Address - Phone:209-845-2553
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-12
Last Update Date:2022-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty