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General NPI Number Information
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NPI Number | 1780145474
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Entity Type | Individual
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Provider Name | JIHYUN PARK
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Gender | Male
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Dates
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Enumeration Date | 03/26/2019
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Last Update Date | 04/19/2019
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Provider Practice Location Address
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Address Line | 1441 KAPIOLANI BLVD STE 1810
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City | HONOLULU
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State | HI
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Zip | 96814-4408
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Country | US
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Telephone | 808-799-6695
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Fax |
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Provider Business Mailing Address
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Address Line | 2640 DOLE ST APT E355
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City | HONOLULU
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State | HI
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Zip | 96822-2342
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Country | US
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Telephone |
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Fax |
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | ACU-1264
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License Number State | HI
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