Provider Demographics
NPI:1639440530
Name:Y K CHUNG ACUPUNCTURE CLINIC
Entity type:Organization
Organization Name:Y K CHUNG ACUPUNCTURE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:L.AC./OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YOUN KOO
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUNG
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:310-534-1797
Mailing Address - Street 1:23540 CRENSHAW BLVD
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-5203
Mailing Address - Country:US
Mailing Address - Phone:310-534-1797
Mailing Address - Fax:310-534-0177
Practice Address - Street 1:23540 CRENSHAW BLVD
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-5203
Practice Address - Country:US
Practice Address - Phone:310-534-1797
Practice Address - Fax:310-534-0177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-24
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC4464171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty