Seunghun Jung, D.C.
Individual provider Active NPI Chiropractor · Ripon, CA
NPI 1235535675 · NPPES record last updated May 14, 2015
Key facts
- NPI
- 1235535675
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- DC 32200 (CA)
- Practice address
- 274 E Wind Dr
Ripon, CA 95366-9454 - Phone
- (209) 284-3342
- Fax
- (209) 645-7849
- NPI assigned
- Nov 12, 2014
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150127002076 | CA | Practitioner - Chiropractic | 1052635851 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC 32200 | CA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brian Herline Chiropractic Inc | Chiropractor | Current |
Accepting new patients |
| Jon Baker Chiropractic Corp | Chiropractor | Past | Accepting new patients |
| United Health Centers of the San Joaquin Valley | Past | Accepting new patients |
Locations
2150 Scenic Dr
Modesto, CA 95355
Phone (209) 527-8560
Interoperability endpoints
- seunghun.jung.1@17661.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC 32200 | CA | Yes |
Addresses
Primary practice location
274 E Wind Dr
Ripon, CA 95366-9454
Mailing address
274 E Wind Dr
Ripon, CA 95366-9454
Phone (209) 284-3342
Other providers in Ripon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 14, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.