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General NPI Number Information
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NPI Number | 1669536579
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Entity Type | Organization
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Legal Business Name | J CHUNG MORITA CHIROPRACTIC INC.
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Dates
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Enumeration Date | 12/22/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1241 GRAND AVE SUITE C
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City | DIAMOND BAR
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State | CA
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Zip | 91765-4447
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Country | US
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Telephone | 909-860-1661
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Fax | 909-860-0125
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Provider Business Mailing Address
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Address Line | 9015 EMPEROR AVE UNIT A
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City | SAN GABRIEL
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State | CA
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Zip | 91775-2065
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Country | US
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Telephone | 626-309-7505
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JONIE CHUNG MORITA
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Credential | D.C.
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Telephone | 909-860-1661
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC 28353
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License Number State | CA
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