Healthcare Provider Details

I. General information

NPI: 1467677765
Provider Name (Legal Business Name): JONG MOON CHUNG L.AC, D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: JONG MOON CHUNG L.AC, D.C.

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25078 PEACHLAND AVE STE E
SANTA CLARITA CA
91321-2551
US

IV. Provider business mailing address

27306 SAND CANYON RD
SANTA CLARITA CA
91387-3631
US

V. Phone/Fax

Practice location:
  • Phone: 661-259-0202
  • Fax:
Mailing address:
  • Phone: 213-760-1415
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberD.C 29799
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberL.AC5772
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: