Provider Demographics
NPI:1013078211
Name:PAEK, JUN H (LAC)
Entity Type:Individual
Prefix:MR
First Name:JUN
Middle Name:H
Last Name:PAEK
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:MR
Other - First Name:ALEX
Other - Middle Name:
Other - Last Name:PAEK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC
Mailing Address - Street 1:1036 E BASTANCHURY RD STE B
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-2794
Mailing Address - Country:US
Mailing Address - Phone:714-582-2422
Mailing Address - Fax:714-582-2360
Practice Address - Street 1:1036 E BASTANCHURY RD STE B
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-2794
Practice Address - Country:US
Practice Address - Phone:714-582-2422
Practice Address - Fax:714-582-2360
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 8089171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist