Provider Demographics
NPI:1013079698
Name:CHUNG, JAMES (AC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:CHUNG
Suffix:
Gender:M
Credentials:AC
Other - Prefix:
Other - First Name:ANSHUN
Other - Middle Name:
Other - Last Name:CHUNG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:AC
Mailing Address - Street 1:25401 CABOT RD
Mailing Address - Street 2:109
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-3496
Mailing Address - Country:US
Mailing Address - Phone:949-837-9425
Mailing Address - Fax:949-837-9415
Practice Address - Street 1:25401 CABOT RD
Practice Address - Street 2:109
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-3496
Practice Address - Country:US
Practice Address - Phone:949-837-9425
Practice Address - Fax:949-837-9415
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 04235171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist