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General NPI Number Information
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NPI Number | 1013699834
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Entity Type | Organization
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Legal Business Name | SUH AND JUNG MYOBALANCE, INC.
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Dates
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Enumeration Date | 08/01/2023
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Last Update Date | 08/01/2023
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Provider Practice Location Address
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Address Line | 3435 WILSHIRE BLVD STE 2311
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City | LOS ANGELES
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State | CA
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Zip | 90010-1901
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Country | US
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Telephone | 213-913-5279
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Fax |
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Provider Business Mailing Address
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Address Line | 909 W TEMPLE ST APT 524A
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City | LOS ANGELES
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State | CA
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Zip | 90012-4441
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Country | US
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Telephone | 213-913-5279
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. JONGRAK JUNG
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Credential | D.C, L.AC
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Telephone | 213-913-5279
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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