Healthcare Provider Details

I. General information

NPI: 1326967613
Provider Name (Legal Business Name): CAPTAIN WORLD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1757 ARMY DR STE 114&115
TAMUNING GU
96913-1260
US

IV. Provider business mailing address

1779 ARMY DR STE 105 #126
TAMUNING GU
96913
US

V. Phone/Fax

Practice location:
  • Phone: 671-489-8458
  • Fax:
Mailing address:
  • Phone: 671-489-8458
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: HUN MIN KOO
Title or Position: OWNER
Credential:
Phone: 671-489-8458