Provider Demographics
NPI:1336433994
Name:HAN, JUN
Entity type:Individual
Prefix:
First Name:JUN
Middle Name:
Last Name:HAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1256 W CHANDLER BLVD
Mailing Address - Street 2:SUITE 19
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-5207
Mailing Address - Country:US
Mailing Address - Phone:480-236-9198
Mailing Address - Fax:480-307-9707
Practice Address - Street 1:1256 W CHANDLER BLVD
Practice Address - Street 2:SUITE 19
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-5207
Practice Address - Country:US
Practice Address - Phone:480-236-9198
Practice Address - Fax:480-307-9707
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-01
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0043171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist