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General NPI Number Information
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NPI Number | 1003000563
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Entity Type | Organization
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Legal Business Name | RICHARD B. D. CHUN, M.D. PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 08/28/2007
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Last Update Date | 04/24/2014
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Provider Practice Location Address
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Address Line | 729 SUNRISE AVE STE 619
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City | ROSEVILLE
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State | CA
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Zip | 95661-4548
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Country | US
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Telephone | 916-783-7118
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Fax |
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Provider Business Mailing Address
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Address Line | 729 SUNRISE AVE STE 619
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City | ROSEVILLE
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State | CA
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Zip | 95661-4548
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Country | US
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Telephone | 916-783-7118
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RICHARD B. CHUN
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Credential | M. D.
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Telephone | 916-783-7118
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | C28231
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | C28231
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License Number State | CA
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