Healthcare Provider Details

I. General information

NPI: 1427960277
Provider Name (Legal Business Name): JAEWON HUR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18822 BEACH BLVD STE 106
HUNTINGTON BEACH CA
92648-2055
US

IV. Provider business mailing address

18822 BEACH BLVD STE 106
HUNTINGTON BEACH CA
92648-2055
US

V. Phone/Fax

Practice location:
  • Phone: 714-898-2580
  • Fax: 714-898-2589
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC20736
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: