Provider Demographics
NPI:1710015425
Name:CHUN, JOSEPH D (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:D
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 1:6261 STANTON AVE
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-2436
Mailing Address - Country:US
Mailing Address - Phone:714-739-4325
Mailing Address - Fax:714-452-1679
Practice Address - Street 1:6261 STANTON AVE
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90621-2436
Practice Address - Country:US
Practice Address - Phone:714-739-4325
Practice Address - Fax:714-452-1679
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG61950207K00000X, 207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR00088840Medicaid
CAGR00088840Medicaid
CAF11312Medicare UPIN