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General NPI Number Information
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NPI Number | 1891139440
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Entity Type | Individual
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Provider Name | SUN MUN JANG LAC
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Gender | Male
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Dates
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Enumeration Date | 04/25/2013
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Last Update Date | 04/25/2013
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Provider Practice Location Address
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Address Line | 445 N GAREY AVE SUITE 4A
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City | POMONA
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State | CA
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Zip | 91767-5422
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Country | US
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Telephone | 213-210-9711
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Fax |
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Provider Business Mailing Address
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Address Line | 445 N GAREY AVE SUITE 4A
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City | POMONA
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State | CA
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Zip | 91767-5422
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Country | US
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Telephone | 213-210-9711
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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 | AC14512
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License Number State | CA
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