Healthcare Provider Details

I. General information

NPI: 1730248444
Provider Name (Legal Business Name): JOON HUH ACUPUNCTURIST
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 04/26/2022
Certification Date: 04/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 N SUNRISE AVE STE 815
ROSEVILLE CA
95661-2928
US

IV. Provider business mailing address

151 N SUNRISE AVE STE 815
ROSEVILLE CA
95661-2928
US

V. Phone/Fax

Practice location:
  • Phone: 916-532-2396
  • Fax: 279-900-8437
Mailing address:
  • Phone: 916-532-2396
  • Fax: 279-900-8437

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC6318
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: