Provider Demographics
NPI:1578940243
Name:SUNG YUP JUNG NP INC
Entity Type:Organization
Organization Name:SUNG YUP JUNG NP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUNG
Authorized Official - Middle Name:YUP
Authorized Official - Last Name:JUNG
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:808-781-8046
Mailing Address - Street 1:1130 N NIMITZ HWY
Mailing Address - Street 2:153
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-4579
Mailing Address - Country:US
Mailing Address - Phone:808-781-8046
Mailing Address - Fax:808-536-8687
Practice Address - Street 1:1130 N NIMITZ HWY
Practice Address - Street 2:153
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-4579
Practice Address - Country:US
Practice Address - Phone:808-781-8046
Practice Address - Fax:808-536-8687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-01
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1629363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty