Provider Demographics
NPI:1053763987
Name:JUN, HYUNGMIN (DC)
Entity type:Individual
Prefix:
First Name:HYUNGMIN
Middle Name:
Last Name:JUN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 LA CADENA WAY APT C
Mailing Address - Street 2:
Mailing Address - City:LA HABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631-4481
Mailing Address - Country:US
Mailing Address - Phone:562-691-6073
Mailing Address - Fax:
Practice Address - Street 1:731 N BEACH BLVD STE 140
Practice Address - Street 2:
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631-3689
Practice Address - Country:US
Practice Address - Phone:562-315-7090
Practice Address - Fax:562-315-7084
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-03
Last Update Date:2016-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31059111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor