Provider Demographics
NPI:1134285794
Name:WON, CHRISTINE HAE-JIN (MD)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:HAE-JIN
Last Name:WON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:HAE-JIN
Other - Last Name:CHI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2720 N HARBOR BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-2626
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2720 N HARBOR BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835
Practice Address - Country:US
Practice Address - Phone:714-449-6990
Practice Address - Fax:714-626-2682
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA72769208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics