Healthcare Provider Details

I. General information

NPI: 1063852002
Provider Name (Legal Business Name): SUNGHEE HONG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2013
Last Update Date: 07/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8610 W 3RD ST
LOS ANGELES CA
90048-3324
US

IV. Provider business mailing address

8610 W 3RD ST
LOS ANGELES CA
90048-3324
US

V. Phone/Fax

Practice location:
  • Phone: 310-734-7539
  • Fax: 310-734-7540
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC13756
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: