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General NPI Number Information
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NPI Number | 1578590899
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Entity Type | Individual
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Provider Name | G. MICHAEL GERARD CHUN M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/26/2006
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Last Update Date | 09/15/2008
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Provider Practice Location Address
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Address Line | 16200 SAND CANYON AVE IRH DEPARTMENT OF RADIOLOGY
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City | IRVINE
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State | CA
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Zip | 92618-3714
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Country | US
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Telephone | 949-753-2365
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Fax | 949-753-2368
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Provider Business Mailing Address
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Address Line | 16200 SAND CANYON AVE IRH DEPARTMENT OF RADIOLOGY
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City | IRVINE
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State | CA
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Zip | 92618-3714
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Country | US
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Telephone | 949-753-2365
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Fax | 949-753-2368
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | A50023
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License Number State | CA
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