Provider Demographics
NPI:1598217267
Name:CHON, HYEUNSOOK
Entity Type:Individual
Prefix:
First Name:HYEUNSOOK
Middle Name:
Last Name:CHON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 BLAKE WILBUR DR
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304-2201
Mailing Address - Country:US
Mailing Address - Phone:650-498-7999
Mailing Address - Fax:650-724-9454
Practice Address - Street 1:900 BLAKE WILBUR DR
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-2201
Practice Address - Country:US
Practice Address - Phone:650-498-7999
Practice Address - Fax:650-724-9454
Is Sole Proprietor?:No
Enumeration Date:2016-10-28
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95005342363LA2200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health