Provider Demographics
NPI:1982118261
Name:HUNG, SHUJUNG (LAC)
Entity Type:Individual
Prefix:
First Name:SHUJUNG
Middle Name:
Last Name:HUNG
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:MELINDA
Other - Middle Name:
Other - Last Name:HUNG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC
Mailing Address - Street 1:2820 RIVERA DR
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-5832
Mailing Address - Country:US
Mailing Address - Phone:650-732-2158
Mailing Address - Fax:650-305-7831
Practice Address - Street 1:441 DE GUIGNE DR STE 101
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94085-3875
Practice Address - Country:US
Practice Address - Phone:650-732-2158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-26
Last Update Date:2017-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17900171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist