Provider Demographics
NPI:1538498183
Name:WOO, JONG DUK
Entity Type:Individual
Prefix:MR
First Name:JONG
Middle Name:DUK
Last Name:WOO
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 1:545 E SAN JOSE AVE
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91501-2600
Mailing Address - Country:US
Mailing Address - Phone:213-605-2258
Mailing Address - Fax:
Practice Address - Street 1:545 E SAN JOSE AVE
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91501-2600
Practice Address - Country:US
Practice Address - Phone:213-605-2258
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-10
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)