Provider Demographics
NPI:1467628842
Name:CHUNG, JUN HEE
Entity Type:Individual
Prefix:
First Name:JUN HEE
Middle Name:
Last Name:CHUNG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9461 FLOWER ST
Mailing Address - Street 2:
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-5705
Mailing Address - Country:US
Mailing Address - Phone:562-714-6361
Mailing Address - Fax:562-867-4733
Practice Address - Street 1:9461 FLOWER ST
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-5705
Practice Address - Country:US
Practice Address - Phone:562-714-6361
Practice Address - Fax:562-867-4733
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC11115171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC 11115OtherACUPUNCTURE BOARD