Provider Demographics
NPI:1124247572
Name:JUNG, KATHIE YOUN (LAC PHD)
Entity type:Individual
Prefix:DR
First Name:KATHIE
Middle Name:YOUN
Last Name:JUNG
Suffix:
Gender:F
Credentials:LAC PHD
Other - Prefix:
Other - First Name:YOUN
Other - Middle Name:KYUNG
Other - Last Name:JUNG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5301 WHITTIER BLVD. ATRIUM STE
Mailing Address - Street 2:
Mailing Address - City:EAST LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90022
Mailing Address - Country:US
Mailing Address - Phone:323-887-7458
Mailing Address - Fax:323-887-8288
Practice Address - Street 1:5301 WHITTIER BLVD. ATRIUM STE
Practice Address - Street 2:
Practice Address - City:EAST LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90022
Practice Address - Country:US
Practice Address - Phone:323-887-7458
Practice Address - Fax:323-887-8288
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC9092171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist