Provider Demographics
NPI:1902161359
Name:HUR, LINDA HYUN-BUM (OD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:HYUN-BUM
Last Name:HUR
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1451 BAIGORRY ST
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95304-5906
Mailing Address - Country:US
Mailing Address - Phone:209-481-9344
Mailing Address - Fax:
Practice Address - Street 1:1420 TARA HILLS DR
Practice Address - Street 2:SUITE D
Practice Address - City:PINOLE
Practice Address - State:CA
Practice Address - Zip Code:94564-2530
Practice Address - Country:US
Practice Address - Phone:510-724-1768
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-11
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14792152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist