MEDICARE: IN SUNG SERVICE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center
2	261QH0100X	Health Service Clinic/Center
3	261QP2000X	Physical Therapy Clinic/Center
4	261QS1200X	Sleep Disorder Diagnostic Clinic/Center
5	261QH0100X	Health Service Clinic/Center	AC 11329	CA

General Provider Information

NPI Number	:	1891095683
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IN SUNG SERVICE, INC.

Provider Business Mailing Address
First Line	:	1134 S WESTERN AVE
Second Line	:	B2
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-2366
Country	:	US
Telephone Number	:	213-283-6166
Fax Number	:

Provider Business Practice Location Address
First Line	:	1134 S WESTERN AVE
Second Line	:	B2
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-2366
Country	:	US
Telephone Number	:	213-283-6166
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BON JA SHIN
Credential	:
Telephone Number	:	213-283-6166

Provider Enumeration Date	:	10/26/2010
Last Update Date	:	10/26/2010

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Directions to “IN SUNG SERVICE, INC. ” Practice Location

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