Healthcare Provider Details

I. General information

NPI: 1508175654
Provider Name (Legal Business Name): STEPHEN S. HONG, M.D., A PROFESSIONAL CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2010
Last Update Date: 10/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

921 W. 7TH STREET
OXNARD CA
93030-6755
US

IV. Provider business mailing address

921 W. 7TH STREET
OXNARD CA
93030-6755
US

V. Phone/Fax

Practice location:
  • Phone: 805-486-1601
  • Fax: 805-487-1094
Mailing address:
  • Phone: 805-486-1601
  • Fax: 805-487-1094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA35437
License Number StateCA

VIII. Authorized Official

Name: STEPHEN S. HONG
Title or Position: OWNER
Credential: M.D.
Phone: 805-486-1601