Healthcare Provider Details

I. General information

NPI: 1841955648
Provider Name (Legal Business Name): YOOLIM HONG MS, RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2021
Last Update Date: 11/05/2021
Certification Date: 10/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4900 CALIFORNIA AVE, TOWER B 2ND FLOOR SUITE 1121
BAKERSFIELD CA
93309
US

IV. Provider business mailing address

10001 CAMINO MEDIA # 20207
BAKERSFIELD CA
93311-1310
US

V. Phone/Fax

Practice location:
  • Phone: 323-546-7784
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133VN1201X
TaxonomyObesity and Weight Management Nutrition Registered Dietitian
License Number86081055
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code133VN1301X
TaxonomyOncology Nutrition Registered Dietitian
License Number86081055
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86081055
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code133VN1005X
TaxonomyRenal Nutrition Registered Dietitian
License Number86081055
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number86081055
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code133VN1101X
TaxonomyGerontological Nutrition Registered Dietitian
License Number86081055
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: