MEDICARE: DR. NOEL LEE CHUN 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	207L00000X	Anesthesiology Physician	A50740	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00A507400	OTHER	CA	BLUE SHIELD OF CA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982638839
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NOEL LEE CHUN M.D.

Provider Business Mailing Address
First Line	:	555 PIER AVE
Second Line	:	SUITE 1
City	:	HERMOSA BEACH
State	:	CA
Zip	:	90254-3839
Country	:	US
Telephone Number	:	310-374-4100
Fax Number	:	310-374-4111

Provider Business Practice Location Address
First Line	:	555 PIER AVE
Second Line	:	SUITE 1
City	:	HERMOSA BEACH
State	:	CA
Zip	:	90254-3839
Country	:	US
Telephone Number	:	310-374-4100
Fax Number	:	310-374-4111

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

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	09/10/2008

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