Provider Demographics
NPI:1467696005
Name:CHU, JI YEUN (LAC)
Entity Type:Individual
Prefix:MS
First Name:JI YEUN
Middle Name:
Last Name:CHU
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20110 S. PIONEER BLVD.
Mailing Address - Street 2:SUITE #E
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703
Mailing Address - Country:US
Mailing Address - Phone:562-860-8300
Mailing Address - Fax:562-860-8311
Practice Address - Street 1:20110 S. PIONEER BLVD.
Practice Address - Street 2:SUITE #E
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703
Practice Address - Country:US
Practice Address - Phone:562-860-8300
Practice Address - Fax:562-860-8311
Is Sole Proprietor?:No
Enumeration Date:2009-04-27
Last Update Date:2009-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC12646171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist