Basic Information
Provider Information
NPI: 1508150798
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HYUN
FirstName: CLARA
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 16111 PLUMMER ST BLDG 200
Address2: 103-C
City: NORTH HILLS
State: CA
PostalCode: 913432036
CountryCode: US
TelephoneNumber: 8188917711
FaxNumber:  
Practice Location
Address1: 16111 PLUMMER ST
Address2:  
City: NORTH HILLS
State: CA
PostalCode: 913432036
CountryCode: US
TelephoneNumber: 8188917711
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/05/2011
LastUpdateDate: 02/27/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XNP18604CAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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