Provider Demographics
NPI:1710686688
Name:SUNG, YUN (LAC)
Entity Type:Individual
Prefix:
First Name:YUN
Middle Name:
Last Name:SUNG
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13788 ROSWELL AVE STE 138
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-1409
Mailing Address - Country:US
Mailing Address - Phone:909-306-7615
Mailing Address - Fax:
Practice Address - Street 1:13788 ROSWELL AVE STE 138
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-1409
Practice Address - Country:US
Practice Address - Phone:909-306-7615
Practice Address - Fax:909-306-7761
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC19632171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist