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Organization
PREMIERE SPINE AND SPORTS MEDICINE
Active
Organization
PREMIERE SPINE AND SPORTS MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONG HYUN GWAG DC (OWNER/CHIROPRACTOR)
(714) 334-6211
Entity
Organization
Contact information
Practice address
2255 E MAPLE AVE, EL SEGUNDO, CA 90245-6508
(310) 322-8777
(310) 322-8787
Mailing address
2255 E MAPLE AVE, EL SEGUNDO, CA 90245-6508
(310) 322-8777
(310) 322-8787
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Enumeration date
10/03/2024
Last updated
10/03/2024
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