Healthcare Provider Details

I. General information

NPI: 1730287129
Provider Name (Legal Business Name): IN HAING HUR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 02/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18781 RAGAN CIR SUITE 607
VILLA PARK CA
92861-3134
US

IV. Provider business mailing address

18781 RAGAN CIR SUITE 607
VILLA PARK CA
92861-3134
US

V. Phone/Fax

Practice location:
  • Phone: 714-974-4680
  • Fax: 714-956-1210
Mailing address:
  • Phone: 714-974-4680
  • Fax: 714-956-1210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA36111
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: