MEDICARE: DR. DAVID JINSUNG JOO D.C.

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	DC30021	CA

General Provider Information

NPI Number	:	1770680928
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID JINSUNG JOO D.C.

Provider Business Mailing Address
First Line	:	4655 RUFFNER ST STE 120
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92111-2226
Country	:	US
Telephone Number	:	858-292-0256
Fax Number	:	858-292-0459

Provider Business Practice Location Address
First Line	:	4655 RUFFNER ST STE 120
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92111-2226
Country	:	US
Telephone Number	:	858-292-0256
Fax Number	:	858-292-0459

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

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	09/04/2020

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