Provider Demographics
NPI:1558809533
Name:HIFUMI, MISUN CHUNG (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:MISUN
Middle Name:CHUNG
Last Name:HIFUMI
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2742 W 234TH ST
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-3118
Mailing Address - Country:US
Mailing Address - Phone:310-387-3363
Mailing Address - Fax:
Practice Address - Street 1:2742 W 234TH ST
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-3118
Practice Address - Country:US
Practice Address - Phone:310-387-3363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-09
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT23909225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist