Healthcare Provider Details

I. General information

NPI: 1144522640
Provider Name (Legal Business Name): MR. JOSEPH HONG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/03/2010
Last Update Date: 12/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 WILSHIRE BLVD STE 485
LOS ANGELES CA
90010-2911
US

IV. Provider business mailing address

3700 WILSHIRE BLVD STE 485
LOS ANGELES CA
90010-2911
US

V. Phone/Fax

Practice location:
  • Phone: 213-389-6400
  • Fax: 888-317-2991
Mailing address:
  • Phone: 213-389-6400
  • Fax: 888-317-2991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License NumberA1975041
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: