Provider Demographics
NPI:1083920144
Name:UNION ROH CHIROPRACTIC GROUP INC
Entity Type:Organization
Organization Name:UNION ROH CHIROPRACTIC GROUP INC
Other - Org Name:UNION ROH CHIROPRACTIC GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TREATING DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:SUN
Authorized Official - Middle Name:HO
Authorized Official - Last Name:ROH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:323-299-7606
Mailing Address - Street 1:3701 STOCKER ST STE 104A
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90008-5145
Mailing Address - Country:US
Mailing Address - Phone:323-299-7606
Mailing Address - Fax:323-299-7636
Practice Address - Street 1:3701 STOCKER ST STE 104A
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90008-5145
Practice Address - Country:US
Practice Address - Phone:323-299-7606
Practice Address - Fax:323-299-7636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-27
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-31539111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty