Healthcare Provider Details

I. General information

NPI: 1942131966
Provider Name (Legal Business Name): ELTON HONG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2358 PINE ST
ROSEMEAD CA
91770-3108
US

IV. Provider business mailing address

2358 PINE ST
ROSEMEAD CA
91770-3108
US

V. Phone/Fax

Practice location:
  • Phone: 626-500-8418
  • Fax:
Mailing address:
  • Phone: 626-500-8418
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number39020000X
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: