Provider Demographics
NPI:1912005489
Name:CHUN, YOUNG K (MD)
Entity Type:Individual
Prefix:
First Name:YOUNG
Middle Name:K
Last Name:CHUN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10150 CENTENNIAL PKWY STE 230
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84070-4123
Mailing Address - Country:US
Mailing Address - Phone:801-993-9530
Mailing Address - Fax:
Practice Address - Street 1:1200 E 3900 S
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84124-1300
Practice Address - Country:US
Practice Address - Phone:801-993-9530
Practice Address - Fax:801-733-5618
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT327012-1205207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT2000002OtherUNITED HEALTHCARE
UT660241OtherDESERET MUTUAL
UT7342OtherHEALTHY U
UTQM0000028492OtherALTIUS
WY120497100Medicaid
UTPRA02428OtherMOLINA
UT52574OtherPEHP
UT870482642CHUOtherEDUCATORS MUTUAL
UT7342OtherHEALTHY U
UT005965029Medicare ID - Type Unspecified