Provider Demographics
NPI:1891139440
Name:JANG, SUN MUN (LAC)
Entity type:Individual
Prefix:
First Name:SUN MUN
Middle Name:
Last Name:JANG
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 N GAREY AVE
Mailing Address - Street 2:SUITE 4A
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91767-5422
Mailing Address - Country:US
Mailing Address - Phone:213-210-9711
Mailing Address - Fax:
Practice Address - Street 1:445 N GAREY AVE
Practice Address - Street 2:SUITE 4A
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-5422
Practice Address - Country:US
Practice Address - Phone:213-210-9711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-25
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC14512171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist