Provider Demographics
NPI:1215219936
Name:JUN, JOONG WON (LAC)
Entity Type:Individual
Prefix:
First Name:JOONG
Middle Name:WON
Last Name:JUN
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 KEEAUMOKU ST
Mailing Address - Street 2:I-208
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-2368
Mailing Address - Country:US
Mailing Address - Phone:808-949-0432
Mailing Address - Fax:
Practice Address - Street 1:825 KEEAUMOKU ST
Practice Address - Street 2:I-208
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-2368
Practice Address - Country:US
Practice Address - Phone:808-949-0432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIACU-897171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist