Healthcare Provider Details

I. General information

NPI: 1720031800
Provider Name (Legal Business Name): PETER VUN CHEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 11/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ONE HOAG DRIVE CANCER CENTER
NEWPORT BEACH CA
92663-4162
US

IV. Provider business mailing address

DEPT LA 21562
PASADENA CA
91185-1562
US

V. Phone/Fax

Practice location:
  • Phone: 949-764-5528
  • Fax: 949-764-8106
Mailing address:
  • Phone: 949-263-8620
  • Fax: 949-263-0473

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberA70756
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: