Provider Demographics
NPI:1548774276
Name:HWANG, HOJUN
Entity type:Individual
Prefix:
First Name:HOJUN
Middle Name:
Last Name:HWANG
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 1:455 CRESCENT ST APT 116
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-2678
Mailing Address - Country:US
Mailing Address - Phone:510-775-3287
Mailing Address - Fax:
Practice Address - Street 1:100 OCONNOR DR STE 31
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-1655
Practice Address - Country:US
Practice Address - Phone:408-295-7380
Practice Address - Fax:408-295-7380
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-16
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17938171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty