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General NPI Number Information
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NPI Number | 1467677765
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Entity Type | Individual
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Provider Name | JONG MOON CHUNG L.AC, D.C.
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Gender | Male
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Dates
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Enumeration Date | 04/13/2007
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Last Update Date | 11/05/2025
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Provider Practice Location Address
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Address Line | 25078 PEACHLAND AVE STE E
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City | SANTA CLARITA
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State | CA
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Zip | 91321-2551
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Country | US
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Telephone | 661-259-0202
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Fax |
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Provider Business Mailing Address
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Address Line | 27306 SAND CANYON RD
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City | SANTA CLARITA
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State | CA
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Zip | 91387-3631
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Country | US
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Telephone | 213-760-1415
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | L.AC5772
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License Number State | CA
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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 | D.C 29799
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License Number State | CA
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