Provider Demographics
NPI:1467663526
Name:CHUNG, MYUNG (ACUPUNCTURIST)
Entity Type:Individual
Prefix:MR
First Name:MYUNG
Middle Name:
Last Name:CHUNG
Suffix:
Gender:M
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4110 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-3406
Mailing Address - Country:US
Mailing Address - Phone:213-386-2580
Mailing Address - Fax:213-386-2582
Practice Address - Street 1:4110 W 3RD ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-3406
Practice Address - Country:US
Practice Address - Phone:213-386-2580
Practice Address - Fax:213-386-2582
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC10545171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist