Healthcare Provider Details

I. General information

NPI: 1386782167
Provider Name (Legal Business Name): KEN B CHON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: KYUNG B CHON MD

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 06/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8522 PAINTER AVE
WHITTIER CA
90602-3335
US

IV. Provider business mailing address

8522 PAINTER AVE
WHITTIER CA
90602-3335
US

V. Phone/Fax

Practice location:
  • Phone: 562-698-6266
  • Fax: 562-945-4530
Mailing address:
  • Phone: 562-698-6266
  • Fax: 562-945-4530

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License NumberA38969
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberA38969
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: