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General NPI Number Information
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NPI Number | 1295149508
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Entity Type | Organization
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Legal Business Name | DR. YONG H JUNG, LTD
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Dates
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Enumeration Date | 06/13/2014
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Last Update Date | 06/13/2014
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Provider Practice Location Address
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Address Line | 5755 S RAINBOW BLVD SUITE 101
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City | LAS VEGAS
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State | NV
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Zip | 89118-2534
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Country | US
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Telephone | 702-331-1333
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Fax | 702-331-0808
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Provider Business Mailing Address
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Address Line | 5755 S RAINBOW BLVD SUITE 101
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City | LAS VEGAS
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State | NV
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Zip | 89118-2534
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Country | US
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Telephone | 702-331-1333
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Fax | 702-331-0808
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Authorized Official
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Title or Position | ASSOCIATE DOCTOR
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Name | DR. KIET MICHAEL LAM
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Credential | D.C.
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Telephone | 702-354-5581
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | B01053
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License Number State | NV
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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 | B01053
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License Number State | NV
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