Provider Demographics
NPI:1639242563
Name:MYUNG SANG MEDICAL CENTER
Entity Type:Organization
Organization Name:MYUNG SANG MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KANG
Authorized Official - Suffix:
Authorized Official - Credentials:LAC DC
Authorized Official - Phone:562-809-2535
Mailing Address - Street 1:11867 ARTESIA BLVD
Mailing Address - Street 2:
Mailing Address - City:ARTESIA
Mailing Address - State:CA
Mailing Address - Zip Code:90701-4002
Mailing Address - Country:US
Mailing Address - Phone:562-809-2535
Mailing Address - Fax:562-809-7714
Practice Address - Street 1:11867 ARTESIA BLVD
Practice Address - Street 2:
Practice Address - City:ARTESIA
Practice Address - State:CA
Practice Address - Zip Code:90701-4002
Practice Address - Country:US
Practice Address - Phone:562-809-2535
Practice Address - Fax:562-809-7714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC24437111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC24437Medicare ID - Type Unspecified
CA63023Medicare UPIN