Healthcare Provider Details

I. General information

NPI: 1932156221
Provider Name (Legal Business Name): MICHAEL J. HER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JUNGHO HER M.D

II. Dates (important events)

Enumeration Date: 05/30/2006
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 LINCOLN AVE
BUENA PARK CA
90620-4148
US

IV. Provider business mailing address

PO BOX 35380
LAS VEGAS NV
89133-5380
US

V. Phone/Fax

Practice location:
  • Phone: 714-522-4009
  • Fax:
Mailing address:
  • Phone: 702-579-3203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberC55223
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number8763
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: