Provider Demographics
NPI:1982946547
Name:JUN, HYEJO (MD)
Entity type:Individual
Prefix:DR
First Name:HYEJO
Middle Name:
Last Name:JUN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5900 STATE FARM DR
Mailing Address - Street 2:
Mailing Address - City:ROHNERT PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94928-2149
Mailing Address - Country:US
Mailing Address - Phone:707-206-3044
Mailing Address - Fax:
Practice Address - Street 1:5900 STATE FARM DR
Practice Address - Street 2:
Practice Address - City:ROHNERT PARK
Practice Address - State:CA
Practice Address - Zip Code:94928-2149
Practice Address - Country:US
Practice Address - Phone:707-206-3044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-21
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN63325207R00000X
CAC197903207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine