MEDICARE: CHUN K. RYU, M.D.

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	2084P0800X	Psychiatry Physician	A25717	CA

General Provider Information

NPI Number	:	1275620429
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHUN K. RYU, M.D.

Provider Business Mailing Address
First Line	:	1633 E 4TH ST
Second Line	:	138
City	:	SANTA ANA
State	:	CA
Zip	:	92701-5163
Country	:	US
Telephone Number	:	714-543-4447
Fax Number	:	714-543-4488

Provider Business Practice Location Address
First Line	:	1633 E 4TH ST
Second Line	:	138
City	:	SANTA ANA
State	:	CA
Zip	:	92701-5163
Country	:	US
Telephone Number	:	714-543-4447
Fax Number	:	714-543-4488

Authorized Official
Title or Position	:	MEDICAL DOCTOR, PSYCHIATRIST
Name	:	DR. CHUN K. RYU
Credential	:	M.D.
Telephone Number	:	714-543-4447

Provider Enumeration Date	:	10/09/2006
Last Update Date	:	10/09/2008

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