Healthcare Provider Details

I. General information

NPI: 1609238898
Provider Name (Legal Business Name): JANE HONG NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2016
Last Update Date: 02/13/2020
Certification Date: 02/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7212 ORANGETHORPE AVE STE 9A
BUENA PARK CA
90621-4668
US

IV. Provider business mailing address

7212 ORANGETHORPE AVE STE 9A
BUENA PARK CA
90621-4668
US

V. Phone/Fax

Practice location:
  • Phone: 714-503-6550
  • Fax:
Mailing address:
  • Phone: 714-503-6550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95003843
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: