Basic Information
| Provider Information | |||||||||
| NPI: | 1275620429 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | CHUN K. RYU, M.D. | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | CHUN K. RYU, M.D. | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1633 E 4TH ST | ||||||||
| Address2: | 138 | ||||||||
| City: | SANTA ANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927015163 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7145434447 | ||||||||
| FaxNumber: | 7145434488 | ||||||||
| Practice Location | |||||||||
| Address1: | 1633 E 4TH ST | ||||||||
| Address2: | 138 | ||||||||
| City: | SANTA ANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927015163 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7145434447 | ||||||||
| FaxNumber: | 7145434488 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/09/2006 | ||||||||
| LastUpdateDate: | 10/09/2008 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | RYU | ||||||||
| AuthorizedOfficialFirstName: | CHUN | ||||||||
| AuthorizedOfficialMiddleName: | K. | ||||||||
| AuthorizedOfficialTitleorPosition: | MEDICAL DOCTOR, PSYCHIATRIST | ||||||||
| AuthorizedOfficialTelephone: | 7145434447 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | M.D. | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | A25717 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.