Provider Demographics
NPI:1306128913
Name:CHUNG, WOO H (PHD, LAC)
Entity type:Individual
Prefix:DR
First Name:WOO
Middle Name:H
Last Name:CHUNG
Suffix:
Gender:M
Credentials:PHD, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3680 WILSHIRE BLVD
Mailing Address - Street 2:108
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-2713
Mailing Address - Country:US
Mailing Address - Phone:213-263-2803
Mailing Address - Fax:213-263-2869
Practice Address - Street 1:3680 WILSHIRE BLVD STE 108
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-2713
Practice Address - Country:US
Practice Address - Phone:949-718-0012
Practice Address - Fax:949-718-0012
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-09
Last Update Date:2017-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC8452171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist