Provider Demographics
NPI:1316912769
Name:CHUNG, RICHARD HOON (DC)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:HOON
Last Name:CHUNG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 SHATTO PL
Mailing Address - Street 2:#200
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-1705
Mailing Address - Country:US
Mailing Address - Phone:213-736-0450
Mailing Address - Fax:
Practice Address - Street 1:505 SHATTO PL
Practice Address - Street 2:#200
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-1705
Practice Address - Country:US
Practice Address - Phone:213-736-0450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC25556111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU71527Medicare UPIN
CAWDC25556AMedicare ID - Type Unspecified