Provider Demographics
NPI:1619954831
Name:CHUN, CHOON WHA (MD)
Entity Type:Individual
Prefix:
First Name:CHOON WHA
Middle Name:
Last Name:CHUN
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:PO BOX 2858
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93539-2858
Mailing Address - Country:US
Mailing Address - Phone:661-729-6854
Mailing Address - Fax:661-729-6864
Practice Address - Street 1:44830 VALLEY CENTRAL WAY
Practice Address - Street 2:SUITE 110
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93536-7207
Practice Address - Country:US
Practice Address - Phone:661-940-6060
Practice Address - Fax:661-940-1616
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA323450207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A32340Medicaid
CAC09254Medicare UPIN
CA00A32340Medicaid