=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093727927
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | WOOKSUN HONG D.C.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/12/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2773 FOLSOM ST #301
-----------------------------------------------------
City | SAN FRANCISCO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94110-3375
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 415-846-2835
-----------------------------------------------------
Fax | 415-821-9631
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2773 FOLSOM ST #301
-----------------------------------------------------
City | SAN FRANCISCO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94110-3375
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 415-846-2835
-----------------------------------------------------
Fax | 415-821-9631
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | DC26067
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------