Provider Demographics
NPI:1093056574
Name:JUN, MIN SUK (DO)
Entity Type:Individual
Prefix:
First Name:MIN SUK
Middle Name:
Last Name:JUN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 PINE ST UNIT 640810
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94164-4732
Mailing Address - Country:US
Mailing Address - Phone:415-357-7066
Mailing Address - Fax:
Practice Address - Street 1:2100 WEBSTER ST STE 416
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2379
Practice Address - Country:US
Practice Address - Phone:415-357-7066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-08
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS019194208800000X
CA18386208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology