MEDICARE: HONG DO MD A PROFESSIONAL CORPORATION

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	174400000X	Specialist	A41726	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790997716
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HONG DO MD A PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	1692 TULLY RD STE 9
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95122-2550
Country	:	US
Telephone Number	:	408-223-6073
Fax Number	:	408-223-8030

Provider Business Practice Location Address
First Line	:	1692 TULLY RD STE 9
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95122-2550
Country	:	US
Telephone Number	:	408-223-6073
Fax Number	:	408-223-8030

Authorized Official
Title or Position	:	DERMATOLOGIST
Name	:	DR. HONG T N DO
Credential	:	MD
Telephone Number	:	408-223-6073

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	04/28/2011

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Directions to “HONG DO MD A PROFESSIONAL CORPORATION ” Practice Location

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