Provider Demographics
NPI:1851332183
Name:SUNG, ALFRED (DC)
Entity Type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:
Last Name:SUNG
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 1:540 RALSTON AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:BELMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94002-2869
Mailing Address - Country:US
Mailing Address - Phone:650-593-2888
Mailing Address - Fax:650-593-2880
Practice Address - Street 1:540 RALSTON AVE
Practice Address - Street 2:SUITE D
Practice Address - City:BELMONT
Practice Address - State:CA
Practice Address - Zip Code:94002-2869
Practice Address - Country:US
Practice Address - Phone:650-593-2888
Practice Address - Fax:650-593-2880
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-263180111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0263180Medicaid
CADC0263180Medicaid
CAU79420Medicare UPIN