Healthcare Provider Details

I. General information

NPI: 1548586639
Provider Name (Legal Business Name): ALICE JENNIFER HON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2010
Last Update Date: 10/14/2022
Certification Date: 10/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5901 E 7TH ST BUILDING 150 (MAIL CODE 07/128)
LONG BEACH CA
90822-5201
US

IV. Provider business mailing address

5901 E 7TH ST BUILDING 150 (MAIL CODE 07/128)
LONG BEACH CA
90822-5201
US

V. Phone/Fax

Practice location:
  • Phone: 609-314-5582
  • Fax:
Mailing address:
  • Phone: 609-314-5582
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P0004X
TaxonomySpinal Cord Injury Medicine Physician
License NumberMD453594
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: