Healthcare Provider Details

I. General information

NPI: 1174470512
Provider Name (Legal Business Name): ALEXANDER T. HONG
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/13/2026
Last Update Date: 03/13/2026
Certification Date: 03/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1975 ZONAL AVE
LOS ANGELES CA
90089-5601
US

IV. Provider business mailing address

1975 ZONAL AVE
LOS ANGELES CA
90089-5601
US

V. Phone/Fax

Practice location:
  • Phone: 626-726-5855
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: