Provider Demographics
NPI:1770680928
Name:JOO, DAVID JINSUNG (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JINSUNG
Last Name:JOO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4655 RUFFNER ST STE 120
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-2226
Mailing Address - Country:US
Mailing Address - Phone:858-292-0256
Mailing Address - Fax:858-292-0459
Practice Address - Street 1:4655 RUFFNER ST STE 120
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-2226
Practice Address - Country:US
Practice Address - Phone:858-292-0256
Practice Address - Fax:858-292-0459
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC30021111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor