MEDICARE: DR. CHRISTOPHER SUN CHUN D.D.S.

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	1223E0200X	Endodontics	65255	CA

General Provider Information

NPI Number	:	1285167049
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER SUN CHUN D.D.S.

Provider Business Mailing Address
First Line	:	22129 SETTLER CT
Second Line	:
City	:	WALNUT
State	:	CA
Zip	:	91789-1480
Country	:	US
Telephone Number	:	909-270-0776
Fax Number	:

Provider Business Practice Location Address
First Line	:	28212 KELLY JOHNSON PKWY STE 290
Second Line	:
City	:	VALENCIA
State	:	CA
Zip	:	91355-5093
Country	:	US
Telephone Number	:	661-254-1924
Fax Number	:

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

Provider Enumeration Date	:	04/09/2017
Last Update Date	:	04/10/2017

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