Healthcare Provider Details

I. General information

NPI: 1992098966
Provider Name (Legal Business Name): ERIK HUR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2011
Last Update Date: 10/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4660 VIEWRIDGE AVE
SAN DIEGO CA
92123-1638
US

IV. Provider business mailing address

4660 VIEWRIDGE AVE
SAN DIEGO CA
92123-1638
US

V. Phone/Fax

Practice location:
  • Phone: 858-565-2510
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number36585
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: