Provider Demographics
NPI:1548274756
Name:CHUNG, STEPHEN SANG-UK (DC, LAC)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:SANG-UK
Last Name:CHUNG
Suffix:
Gender:M
Credentials:DC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3447 TORRANCE BLVD
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-5801
Mailing Address - Country:US
Mailing Address - Phone:310-792-4373
Mailing Address - Fax:310-792-4372
Practice Address - Street 1:3447 TORRANCE BLVD
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-5801
Practice Address - Country:US
Practice Address - Phone:310-792-4373
Practice Address - Fax:310-792-4372
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27215111N00000X
CAAC6979171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAV05366Medicare UPIN
CADC27215Medicare PIN