Individual
MARDY CHHUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4283 EL CAJON BLVD STE 100, SAN DIEGO, CA 92105-1289
(619) 521-1743
Mailing address
9465 FARNHAM ST # 92123, SAN DIEGO, CA 92123-1308
(858) 573-2600
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
CA
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
09/15/2016
Last updated
08/03/2023
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