Purun Spine and Arthro Clinic

Primary specialty

Independent Medical Examiner ChiropractorTaxonomy code 111NI0013X

License

24102 Issued in CA

Legal business name

PURUN SPINE AND ARTHRO CLINIC

Practice address

2140 W Olympic Blvd
Suite 405
Los Angeles, CA 90006-2207

Phone

(323) 939-0807

Fax

(213) 674-7908

NPI assigned

Sep 25, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Soungdon Chung, D.CNPI 1942477229

Title

Ceo

Phone

(323) 939-0807

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Soungdon Chung, D.C

  • Independent Medical Examiner Chiropractor
  • Los Angeles, CA
  • NPI 1942477229
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1443139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443139200000",
    "number": "1316317902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 W. OLYMPIC BLVD.,",
            "address_2": "SUITE 405",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90006",
            "telephone_number": "323-939-0807",
            "fax_number": "213-674-7908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2140 W OLYMPIC BLVD",
            "address_2": "SUITE 405",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900062207",
            "telephone_number": "323-939-0807",
            "fax_number": "213-674-7908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURUN SPINE AND ARTHRO CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-25",
        "last_updated": "2015-09-25",
        "status": "A",
        "authorized_official_last_name": "CHUNG",
        "authorized_official_first_name": "SOUNGDON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "323-939-0807",
        "authorized_official_credential": "D.C"
    },
    "taxonomies": [
        {
            "code": "111NI0013X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Independent Medical Examiner",
            "state": "CA",
            "license": "24102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Eisha Eishawndra Purvis, RN
• Scott David Purvis, AMFT
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• Pushkin Medical Inc
• Robert Sheldon Pushkin, MD

• Independent Medical Examiner Chiropractor in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Independent Medical Examiner Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.