Provider Demographics
NPI:1730248444
Name:HUH, JOON (ACUPUNCTURIST)
Entity type:Individual
Prefix:
First Name:JOON
Middle Name:
Last Name:HUH
Suffix:
Gender:M
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 N SUNRISE AVE STE 815
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-2928
Mailing Address - Country:US
Mailing Address - Phone:916-532-2396
Mailing Address - Fax:279-900-8437
Practice Address - Street 1:151 N SUNRISE AVE STE 815
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-2928
Practice Address - Country:US
Practice Address - Phone:916-532-2396
Practice Address - Fax:279-900-8437
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC6318171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC0063180Medicaid