Provider Demographics
NPI:1699934869
Name:HUR-SON, JONG HYEON (LAC)
Entity type:Individual
Prefix:MRS
First Name:JONG
Middle Name:HYEON
Last Name:HUR-SON
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18822 BEACH BLVD STE 106
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-2055
Mailing Address - Country:US
Mailing Address - Phone:714-898-2580
Mailing Address - Fax:714-898-2589
Practice Address - Street 1:18822 BEACH BLVD STE 106
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-2055
Practice Address - Country:US
Practice Address - Phone:714-898-2580
Practice Address - Fax:714-898-2589
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC12421171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist