MEDICARE: MYUNG JI HONG L.AC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	AC14686	CA

General Provider Information

NPI Number	:	1437402369
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MYUNG JI HONG L.AC

Provider Business Mailing Address
First Line	:	7946 IVANHOE AVE STE 303
Second Line	:
City	:	LA JOLLA
State	:	CA
Zip	:	92037-4518
Country	:	US
Telephone Number	:	858-699-9838
Fax Number	:

Provider Business Practice Location Address
First Line	:	7946 IVANHOE AVE STE 303
Second Line	:
City	:	LA JOLLA
State	:	CA
Zip	:	92037-4518
Country	:	US
Telephone Number	:	858-699-9838
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/16/2012
Last Update Date	:	01/31/2018

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