Provider Demographics
NPI:1093196255
Name:GU, HANMO (DC)
Entity Type:Individual
Prefix:
First Name:HANMO
Middle Name:
Last Name:GU
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3510 TORRANCE BLVD.
Mailing Address - Street 2:STE 106
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503
Mailing Address - Country:US
Mailing Address - Phone:310-540-9991
Mailing Address - Fax:310-634-1889
Practice Address - Street 1:3510 TORRANCE BLVD.
Practice Address - Street 2:STE 106
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503
Practice Address - Country:US
Practice Address - Phone:310-540-9991
Practice Address - Fax:310-634-1889
Is Sole Proprietor?:No
Enumeration Date:2015-06-13
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33299111N00000X
CADC33299111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor