Healthcare Provider Details

I. General information

NPI: 1437112513
Provider Name (Legal Business Name): LORRAINE Y CHUN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 09/18/2024
Certification Date: 09/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12520 PALM DR
DESERT HOT SPRINGS CA
92240-4559
US

IV. Provider business mailing address

78219 KENSINGTON AVE
PALM DESERT CA
92211-2324
US

V. Phone/Fax

Practice location:
  • Phone: 760-416-3770
  • Fax: 858-634-6964
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number64318
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: