Provider Demographics
NPI:1649582958
Name:CHUNG, SOON K (DACN,LAC)
Entity Type:Individual
Prefix:DR
First Name:SOON
Middle Name:K
Last Name:CHUNG
Suffix:
Gender:F
Credentials:DACN,LAC
Other - Prefix:
Other - First Name:SOON
Other - Middle Name:K
Other - Last Name:CHUNG-JUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3680 WILSHIRE BLVD. #108
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010
Mailing Address - Country:US
Mailing Address - Phone:213-263-2803
Mailing Address - Fax:213-263-2869
Practice Address - Street 1:3680 WILSHIRE BLVD. #108
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010
Practice Address - Country:US
Practice Address - Phone:213-263-2803
Practice Address - Fax:213-263-2869
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC13685171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist