MEDICARE: JACK CHUNG ACUPUNCTURIST

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	10317	CA

General Provider Information

NPI Number	:	1356411789
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACK CHUNG ACUPUNCTURIST

Provider Business Mailing Address
First Line	:	2819 WHIPPLE RD
Second Line	:
City	:	UNION CITY
State	:	CA
Zip	:	94587-1233
Country	:	US
Telephone Number	:	510-489-8348
Fax Number	:	510-429-6986

Provider Business Practice Location Address
First Line	:	2819 WHIPPLE RD
Second Line	:
City	:	UNION CITY
State	:	CA
Zip	:	94587-1233
Country	:	US
Telephone Number	:	510-489-8348
Fax Number	:	510-429-6986

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/09/2006
Last Update Date	:	07/08/2007

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Directions to “ JACK CHUNG ACUPUNCTURIST” Practice Location

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