Provider Demographics
NPI:1629216486
Name:JUNGAM GROUP
Entity type:Organization
Organization Name:JUNGAM GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:SUH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-922-9508
Mailing Address - Street 1:4010 BARRANCA PKWY
Mailing Address - Street 2:SUITE 250
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-4711
Mailing Address - Country:US
Mailing Address - Phone:949-551-0023
Mailing Address - Fax:949-551-0024
Practice Address - Street 1:4010 BARRANCA PKWY
Practice Address - Street 2:SUITE 250
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-4711
Practice Address - Country:US
Practice Address - Phone:949-551-0023
Practice Address - Fax:949-551-0024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-30
Last Update Date:2009-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC9815171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty