Provider Demographics
NPI:1831462373
Name:BANG, SUNIL (ACUPUNCTURIST)
Entity Type:Individual
Prefix:
First Name:SUNIL
Middle Name:
Last Name:BANG
Suffix:
Gender:M
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 W 6TH ST STE 204
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-1564
Mailing Address - Country:US
Mailing Address - Phone:213-800-1530
Mailing Address - Fax:213-263-2848
Practice Address - Street 1:3000 W 6TH ST STE 204
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-1564
Practice Address - Country:US
Practice Address - Phone:213-800-1530
Practice Address - Fax:213-263-2848
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-14
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC14261171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist