Provider Demographics
NPI:1295149508
Name:DR. YONG H JUNG, LTD
Entity type:Organization
Organization Name:DR. YONG H JUNG, LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KIET
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:LAM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:702-354-5581
Mailing Address - Street 1:5755 S RAINBOW BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-2534
Mailing Address - Country:US
Mailing Address - Phone:702-331-1333
Mailing Address - Fax:702-331-0808
Practice Address - Street 1:5755 S RAINBOW BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-2534
Practice Address - Country:US
Practice Address - Phone:702-331-1333
Practice Address - Fax:702-331-0808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-13
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB01053261QH0100X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth ServiceGroup - Single Specialty