Provider Demographics
NPI:1598241937
Name:CHUNG, ELLA Y (ACUPUNCTURIST)
Entity Type:Individual
Prefix:DR
First Name:ELLA
Middle Name:Y
Last Name:CHUNG
Suffix:
Gender:F
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:YEO JIN
Other - Middle Name:
Other - Last Name:CHUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1631 W 219TH ST APT 202
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-3890
Mailing Address - Country:US
Mailing Address - Phone:213-369-7574
Mailing Address - Fax:
Practice Address - Street 1:1225 W 190TH ST STE 425
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90248-4340
Practice Address - Country:US
Practice Address - Phone:213-369-7574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-18
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC14065171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist