Healthcare Provider Details

I. General information

NPI: 1134143506
Provider Name (Legal Business Name): JAMES G CHUN JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 04/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2250 HAYES ST SUITE 204
SAN FRANCISCO CA
94117-1078
US

IV. Provider business mailing address

2250 HAYES ST SUITE 204
SAN FRANCISCO CA
94117-1078
US

V. Phone/Fax

Practice location:
  • Phone: 415-933-9100
  • Fax: 415-933-9133
Mailing address:
  • Phone: 415-933-9100
  • Fax: 415-933-9133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberG75949
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberG75949
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberG75949
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: