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General NPI Number Information
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NPI Number | 1407671902
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Entity Type | Individual
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Provider Name | JUN GERMAN JR.
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Gender | Male
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Dates
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Enumeration Date | 11/19/2024
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 15-1440 18TH AVENUE
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City | KEA'AU
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State | HI
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Zip | 96749
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Country | US
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Telephone | 808-968-9700
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Fax | 808-968-2714
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Provider Business Mailing Address
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Address Line | PO BOX 23
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City | MOUNTAIN VIEW
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State | HI
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Zip | 96771-0023
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Country | US
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Telephone | 808-825-0932
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Fax | 808-968-2714
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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 | 253J00000X
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Taxonomy Name | Foster Care Agency
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License Number | 2-240071
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License Number State | HI
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