MEDICARE: SUNG SIM CHIROPRACTIC AND ACUPUNCTURE INC.

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	111N00000X	Chiropractor	D26932	CA

General Provider Information

NPI Number	:	1720244676
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNG SIM CHIROPRACTIC AND ACUPUNCTURE INC.

Provider Business Mailing Address
First Line	:	2675 W OLYMPIC BLVD
Second Line	:	203
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-2880
Country	:	US
Telephone Number	:	213-480-0778
Fax Number	:	213-480-7636

Provider Business Practice Location Address
First Line	:	2675 W OLYMPIC BLVD
Second Line	:	203
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-2880
Country	:	US
Telephone Number	:	213-480-0778
Fax Number	:	213-480-7636

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. HYUNG MO SUNG
Credential	:	D.C.
Telephone Number	:	213-480-0778

Provider Enumeration Date	:	07/31/2008
Last Update Date	:	05/08/2009

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