Healthcare Provider Details

I. General information

NPI: 1982457891
Provider Name (Legal Business Name): CHESIMJUNG ACUCHIRO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2024
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6122 ORANGETHORPE AVE STE 107
BUENA PARK CA
90620-1343
US

IV. Provider business mailing address

6122 ORANGETHORPE AVE STE 107
BUENA PARK CA
90620-1343
US

V. Phone/Fax

Practice location:
  • Phone: 714-724-5786
  • Fax: 714-463-1568
Mailing address:
  • Phone: 714-724-5786
  • Fax: 714-463-1568

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: DR. DONG GWON HAN
Title or Position: CEO
Credential: DC, DAOM, LAC
Phone: 714-724-5786