MEDICARE: ERICA P CHUN MD

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	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	200100853	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C54948	OTHER	CA	MEDICAL LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881672681
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERICA P CHUN MD

Provider Business Mailing Address
First Line	:	PO BOX 660566
Second Line	:
City	:	ARCADIA
State	:	CA
Zip	:	91066-0566
Country	:	US
Telephone Number	:	626-447-0296
Fax Number	:	626-447-6057

Provider Business Practice Location Address
First Line	:	3410 FIR ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92104-5706
Country	:	US
Telephone Number	:	704-451-3305
Fax Number	:

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

Provider Enumeration Date	:	01/03/2006
Last Update Date	:	11/04/2014

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Directions to “ ERICA P CHUN MD” Practice Location

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