Provider Demographics
NPI:1881884591
Name:CHEN, DASUN (MD)
Entity type:Individual
Prefix:DR
First Name:DASUN
Middle Name:
Last Name:CHEN
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 1:355 PLACENTIA AVE
Mailing Address - Street 2:SUITE #303
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-3311
Mailing Address - Country:US
Mailing Address - Phone:949-631-6299
Mailing Address - Fax:
Practice Address - Street 1:355 PLACENTIA AVE
Practice Address - Street 2:SUITE #303
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3311
Practice Address - Country:US
Practice Address - Phone:949-631-6299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA060410207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH22724Medicare UPIN