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General NPI Number Information
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NPI Number | 1982811378
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Entity Type | Individual
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Provider Name | KELLEY YIN-CHING WUNG D.C., MSPT, L.AC.
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Gender | Female
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 06/27/2008
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Provider Practice Location Address
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Address Line | 12416 CLEARGLEN AVE APT 4
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City | WHITTIER
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State | CA
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Zip | 90604-3841
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Country | US
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Telephone | 323-854-2353
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Fax |
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Provider Business Mailing Address
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Address Line | 12416 CLEARGLEN AVE APT 4
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City | WHITTIER
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State | CA
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Zip | 90604-3841
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Country | US
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Telephone | 323-854-2353
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC30509
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC11614
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT29435
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License Number State | CA
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