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General NPI Number Information
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NPI Number | 1881945822
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Entity Type | Organization
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Legal Business Name | HONG CHIROPRACTIC, A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 10/01/2012
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Last Update Date | 10/01/2012
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Provider Practice Location Address
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Address Line | 556 W VALLEY BLVD
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City | COLTON
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State | CA
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Zip | 92324-2249
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Country | US
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Telephone | 909-824-1234
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Fax | 909-423-0510
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Provider Business Mailing Address
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Address Line | 556 W VALLEY BLVD
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City | COLTON
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State | CA
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Zip | 92324-2249
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Country | US
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Telephone | 909-824-1234
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Fax | 909-423-0510
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KENNETH H HONG
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Credential | D.C.
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Telephone | 909-824-1234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC-14585
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC-30750
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License Number State | CA
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