Provider Demographics
NPI:1225202732
Name:CHA, JIN KYUNG (ACUPUNCTURIST)
Entity Type:Individual
Prefix:MRS
First Name:JIN KYUNG
Middle Name:
Last Name:CHA
Suffix:
Gender:F
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:665 N TUSTIN ST
Mailing Address - Street 2:# Y
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-7146
Mailing Address - Country:US
Mailing Address - Phone:714-628-0047
Mailing Address - Fax:714-628-0061
Practice Address - Street 1:665 N TUSTIN ST
Practice Address - Street 2:# Y
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92867-7146
Practice Address - Country:US
Practice Address - Phone:714-628-0047
Practice Address - Fax:714-628-0061
Is Sole Proprietor?:No
Enumeration Date:2008-04-15
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC11911171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist