Provider Demographics
NPI:1346376068
Name:CHUNG, YOUNG SOON (LAC, PHD)
Entity Type:Individual
Prefix:DR
First Name:YOUNG
Middle Name:SOON
Last Name:CHUNG
Suffix:
Gender:F
Credentials:LAC, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:19682 HESPERIAN BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-4752
Mailing Address - Country:US
Mailing Address - Phone:510-887-7697
Mailing Address - Fax:510-887-6365
Practice Address - Street 1:19682 HESPERIAN BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-4752
Practice Address - Country:US
Practice Address - Phone:510-887-7697
Practice Address - Fax:510-887-6365
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC4808171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist