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NPI Code Detail

MEDICARE: DR. LYDIA SUNKYUNG CHUN PSY.D

MEDICARE: DR. LYDIA SUNKYUNG CHUN PSY.D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologistPSY23921CA

General Provider Information

NPI Number : 1417259524
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LYDIA SUNKYUNG CHUN PSY.D
Provider Business Mailing Address
First Line : 6251 STANTON AVE
Second Line :
City : BUENA PARK
State : CA
Zip : 90621-2436
Country : US
Telephone Number : 714-522-4438
Fax Number : 714-522-4430
Provider Business Practice Location Address
First Line : 6251 STANTON AVE
Second Line :
City : BUENA PARK
State : CA
Zip : 90621-2436
Country : US
Telephone Number : 714-522-4438
Fax Number : 714-522-4430
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2010
Last Update Date : 12/02/2024

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