Basic Information
| Provider Information | |||||||||
| NPI: | 1053329276 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHUN | ||||||||
| FirstName: | STEPHANIE | ||||||||
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| Credential: | P.T.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1832 RIBISI WAY | ||||||||
| Address2: | |||||||||
| City: | SAN JOSE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 951312744 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4087739000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1195 E ARQUES AVE | ||||||||
| Address2: | |||||||||
| City: | SUNNYVALE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940853904 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4087739000 | ||||||||
| FaxNumber: | 4087207015 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/03/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | AT1273 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.