Provider Demographics
NPI:1942221155
Name:SIT, CHUN PANG (LAC)
Entity Type:Individual
Prefix:MR
First Name:CHUN
Middle Name:PANG
Last Name:SIT
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5721 FALLENWOOD LN
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-4345
Mailing Address - Country:US
Mailing Address - Phone:858-278-6288
Mailing Address - Fax:858-278-6188
Practice Address - Street 1:4646 CONVOY ST
Practice Address - Street 2:SUITE 105
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-2315
Practice Address - Country:US
Practice Address - Phone:858-278-6288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC0025940171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist