Provider Demographics
NPI:1457452716
Name:JUNG, YONG H (DC MS)
Entity Type:Individual
Prefix:DR
First Name:YONG
Middle Name:H
Last Name:JUNG
Suffix:
Gender:M
Credentials:DC MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 S DECATUR BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89107-3910
Mailing Address - Country:US
Mailing Address - Phone:702-870-7582
Mailing Address - Fax:702-870-7583
Practice Address - Street 1:505 S DECATUR BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89107-3910
Practice Address - Country:US
Practice Address - Phone:702-870-7582
Practice Address - Fax:702-870-7583
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB00880111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U91355Medicare UPIN
NVV38623Medicare ID - Type Unspecified