Provider Demographics
NPI:1982638839
Name:CHUN, NOEL LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:NOEL
Middle Name:LEE
Last Name:CHUN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:555 PIER AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:HERMOSA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90254-3839
Mailing Address - Country:US
Mailing Address - Phone:310-374-4100
Mailing Address - Fax:310-374-4111
Practice Address - Street 1:555 PIER AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:HERMOSA BEACH
Practice Address - State:CA
Practice Address - Zip Code:90254-3839
Practice Address - Country:US
Practice Address - Phone:310-374-4100
Practice Address - Fax:310-374-4111
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA50740207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A507400OtherBLUE SHIELD OF CA
CA00A507400Medicaid
F32790Medicare UPIN
CAWA50740CMedicare ID - Type Unspecified