Chung, Tae Sub
Chung, Tae Sub is an individual health care provider with primary practice located at 15622 S Crenshaw Blvd Ste B, Gardena CA 90249-4528. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Chung, Tae Sub can be contacted via phone (310) 323-9922.Contact Information
Primary practice address
15622 S Crenshaw Blvd Ste B
Gardena CA 90249-4528
Phone: (310) 323-9922
Fax: (310) 515-3551
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 26363 | California |
Profile Details
| NPI number | 1497967566 |
|---|---|
| LBN Legal business name | Chung, Tae Sub |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 3rd, 2007 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1497967566 | NPPES |
| California | Other | B2636301 | DENTICAL |
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