Provider Demographics
NPI:1326700576
Name:CHIROBALANCE DR. JUNG CHIROPRACTIC & ACUPUNCTURE CLINIC, INC
Entity Type:Organization
Organization Name:CHIROBALANCE DR. JUNG CHIROPRACTIC & ACUPUNCTURE CLINIC, INC
Other - Org Name:CHIROBALANCE & ACUPUNCTURE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JONGRAK
Authorized Official - Middle Name:
Authorized Official - Last Name:JUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:206-966-1600
Mailing Address - Street 1:909 W TEMPLE ST APT 524
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-4441
Mailing Address - Country:US
Mailing Address - Phone:206-966-1600
Mailing Address - Fax:
Practice Address - Street 1:3435 WILSHIRE BLVD STE 2311
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-1901
Practice Address - Country:US
Practice Address - Phone:206-966-1600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-05
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty