Provider Demographics
NPI:1891001467
Name:CHUN, BOBBY (DDS)
Entity Type:Individual
Prefix:DR
First Name:BOBBY
Middle Name:
Last Name:CHUN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26305 ANTONIO CIR
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-6731
Mailing Address - Country:US
Mailing Address - Phone:909-237-1800
Mailing Address - Fax:
Practice Address - Street 1:26305 ANTONIO CIR
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-6731
Practice Address - Country:US
Practice Address - Phone:909-237-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-20
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA596641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice