MEDICARE: ELIZABETH CHUN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	18970	CA

General Provider Information

NPI Number	:	1053112433
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH CHUN

Provider Business Mailing Address
First Line	:	1200 N STATE ST STE A7D
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90089-1001
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 N STATE ST STE A7D
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90089-1001
Country	:	US
Telephone Number	:	323-409-7556
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/21/2025
Last Update Date	:	04/17/2026

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Directions to “ ELIZABETH CHUN ” Practice Location

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