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General NPI Number Information
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NPI Number | 1891095683
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Entity Type | Organization
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Legal Business Name | IN SUNG SERVICE, INC.
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Dates
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Enumeration Date | 10/26/2010
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Last Update Date | 10/26/2010
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Provider Practice Location Address
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Address Line | 1134 S WESTERN AVE B2
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City | LOS ANGELES
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State | CA
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Zip | 90006-2366
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Country | US
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Telephone | 213-283-6166
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Fax |
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Provider Business Mailing Address
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Address Line | 1134 S WESTERN AVE B2
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City | LOS ANGELES
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State | CA
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Zip | 90006-2366
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Country | US
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Telephone | 213-283-6166
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | BON JA SHIN
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Credential |
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Telephone | 213-283-6166
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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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 | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | AC 11329
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License Number State | CA
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