Provider Demographics
NPI:1790049104
Name:CHIN, BYUNG MOON (MD)
Entity Type:Individual
Prefix:DR
First Name:BYUNG
Middle Name:MOON
Last Name:CHIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:BYUNG
Other - Middle Name:MOON
Other - Last Name:CHIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3921 WOODCLIFF RD
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-5055
Mailing Address - Country:US
Mailing Address - Phone:818-371-8402
Mailing Address - Fax:
Practice Address - Street 1:3921 WOODCLIFF RD
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-5055
Practice Address - Country:US
Practice Address - Phone:818-371-8402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-29
Last Update Date:2024-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.0138752080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology