Healthcare Provider Details

I. General information

NPI: 1396975686
Provider Name (Legal Business Name): CAROL HONG CHIROPRACTIC CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2009
Last Update Date: 11/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21127 HAWTHORNE BLVD
TORRANCE CA
90503-4615
US

IV. Provider business mailing address

21127 HAWTHORNE BLVD
TORRANCE CA
90503-4615
US

V. Phone/Fax

Practice location:
  • Phone: 310-316-0066
  • Fax: 310-316-0060
Mailing address:
  • Phone: 310-316-0066
  • Fax: 310-316-0060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC29197
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC10606
License Number StateCA

VIII. Authorized Official

Name: DR. CAROL HONG
Title or Position: CEO
Credential: D.C, LAC
Phone: 310-316-0066