Provider Demographics
NPI:1831367044
Name:WANG, JUN (ACUPUNCTURIST)
Entity type:Individual
Prefix:
First Name:JUN
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 BRIARWOOD
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-3756
Mailing Address - Country:US
Mailing Address - Phone:949-413-5834
Mailing Address - Fax:714-956-0200
Practice Address - Street 1:14795 JEFFREY RD STE 103
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-0417
Practice Address - Country:US
Practice Address - Phone:949-413-5834
Practice Address - Fax:714-956-0200
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-11
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC5094171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist