Active NPI
Peter Chun
- Pediatrics Physician
- Loma Linda, CA
National Provider Identifier
1154958072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 178705
- Practice address
- 11234 Anderson St
Loma Linda, CA 92354-2804 - Phone
- (909) 558-4174
- NPI assigned
- Mar 23, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatrics Physician | 208000000X | 178705 | CA | Primary |
Addresses
Primary practice location
11234 Anderson St
Loma Linda, CA 92354-2804
Mailing address
11175 Campus Street Coleman Pavilion A1121
Loma Linda, CA 92350-0001
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Care Compare profile
Medicare Care Compare- Specialty
- Pediatric Medicine
- Education
- Loma Linda University School of Medicine, 2020
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
File Number
Suite 54701
Los Angeles, CA 90074-0001
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 178705 | CA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1584921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656892800000",
"number": "1154958072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11175 CAMPUS STREET COLEMAN PAVILION A1121",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923500001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11234 ANDERSON ST",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923542804",
"telephone_number": "909-558-4174"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHUN",
"first_name": "PETER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-03-23",
"last_updated": "2022-07-04",
"certification_date": "2022-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "178705",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Loma Linda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.