Provider Demographics
NPI:1538497409
Name:CHUNG CHIROPRACTIC CORPORATION
Entity Type:Organization
Organization Name:CHUNG CHIROPRACTIC CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEKSANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:916-285-9387
Mailing Address - Street 1:1960 DEL PASO RD
Mailing Address - Street 2:SUITE 145
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-7708
Mailing Address - Country:US
Mailing Address - Phone:916-285-9387
Mailing Address - Fax:916-285-9355
Practice Address - Street 1:1960 DEL PASO RD
Practice Address - Street 2:SUITE 145
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834-7708
Practice Address - Country:US
Practice Address - Phone:916-285-9387
Practice Address - Fax:916-285-9355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-03
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 26615111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty