Healthcare Provider Details
I. General information
NPI: 1326333147
Provider Name (Legal Business Name): PAUL SEUNGPYO HONG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/09/2011
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2800 L ST STE 500
SACRAMENTO CA
95816-5616
US
IV. Provider business mailing address
10470 OLD PLACERVILLE RD STE 100
SACRAMENTO CA
95827-2539
US
V. Phone/Fax
- Phone: 916-454-6850
- Fax: 916-454-6852
- Phone: 800-470-0071
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | MD457557 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | 6501 |
| License Number State | NE |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207XS0117X |
| Taxonomy | Orthopaedic Surgery of the Spine Physician |
| License Number | MD457557 |
| License Number State | PA |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207XS0117X |
| Taxonomy | Orthopaedic Surgery of the Spine Physician |
| License Number | A149259 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: