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General NPI Number Information
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NPI Number | 1043555766
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Entity Type | Individual
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Provider Name | MOON JEAN HO N.D.
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Gender | Female
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Dates
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Enumeration Date | 12/06/2012
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Last Update Date | 12/06/2012
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Provider Practice Location Address
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Address Line | 15-2891 MAIN GOVERNMENT ROAD
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City | PAHOA
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State | HI
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Zip | 96778
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Country | US
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Telephone | 808-965-2233
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Fax | 808-965-2082
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Provider Business Mailing Address
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Address Line | P.O. BOX 1233
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City | PAHOA
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State | HI
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Zip | 96778
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Country | US
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Telephone | 808-965-2233
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Fax | 808-965-2082
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number | ND240
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License Number State | HI
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