Provider Demographics
NPI:1144355561
Name:CHUNG, SARA P (LICENSED ACUPUNCTURI)
Entity type:Individual
Prefix:MS
First Name:SARA
Middle Name:P
Last Name:CHUNG
Suffix:
Gender:F
Credentials:LICENSED ACUPUNCTURI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 EL CAMINO REAL
Mailing Address - Street 2:#403
Mailing Address - City:MILLBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94030
Mailing Address - Country:US
Mailing Address - Phone:650-697-4211
Mailing Address - Fax:
Practice Address - Street 1:475 EL CAMINO REAL
Practice Address - Street 2:#403
Practice Address - City:MILLBRAE
Practice Address - State:CA
Practice Address - Zip Code:94030
Practice Address - Country:US
Practice Address - Phone:650-697-4211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC2176171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist