Provider Demographics
NPI:1124311386
Name:IN JUNG ACUPUNCTURE
Entity type:Organization
Organization Name:IN JUNG ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:IN
Authorized Official - Middle Name:JEONG
Authorized Official - Last Name:OH
Authorized Official - Suffix:
Authorized Official - Credentials:AC
Authorized Official - Phone:213-368-0377
Mailing Address - Street 1:975 S KENMORE AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90006-1520
Mailing Address - Country:US
Mailing Address - Phone:213-368-0377
Mailing Address - Fax:213-368-0366
Practice Address - Street 1:975 S KENMORE AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-1520
Practice Address - Country:US
Practice Address - Phone:213-368-0377
Practice Address - Fax:213-368-0366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-20
Last Update Date:2011-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC7469171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty