Healthcare Provider Details

I. General information

NPI: 1053578161
Provider Name (Legal Business Name): HOYMAN HONG, MD A PROF MED CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2008
Last Update Date: 10/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1199 BUSH ST 300
SAN FRANCISCO CA
94109-5999
US

IV. Provider business mailing address

34 N SAN MATEO DR SUITE #2
SAN MATEO CA
94401-2824
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-6464
  • Fax: 415-353-6462
Mailing address:
  • Phone: 650-513-6651
  • Fax: 650-350-4395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License NumberA68161
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberA68161
License Number StateCA

VIII. Authorized Official

Name: HOYMAN HONG
Title or Position: PRESIDENT
Credential: M.D.
Phone: 415-797-2453