Provider Demographics
NPI:1982811378
Name:WUNG, KELLEY YIN-CHING (DC, MSPT, LAC)
Entity Type:Individual
Prefix:DR
First Name:KELLEY
Middle Name:YIN-CHING
Last Name:WUNG
Suffix:
Gender:F
Credentials:DC, MSPT, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12416 CLEARGLEN AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90604-3841
Mailing Address - Country:US
Mailing Address - Phone:323-854-2353
Mailing Address - Fax:
Practice Address - Street 1:12416 CLEARGLEN AVE APT 4
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90604-3841
Practice Address - Country:US
Practice Address - Phone:323-854-2353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC30509111N00000X
CAAC11614171100000X
CAPT29435225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist