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NPI Code Detail

MEDICARE: DAVID D.Y. HONG P.A.

MEDICARE: DAVID D.Y. HONG P.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA916KY
2363A00000XPhysician AssistantPA-134GU

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000524207OTHERKYBCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
31066346OTHERWVBRICKSTREET

General Provider Information

NPI Number : 1457300923
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID D.Y. HONG P.A.
Provider Business Mailing Address
First Line : PO BOX 409013
Second Line :
City : ATLANTA
State : GA
Zip : 30384-9013
Country : US
Telephone Number : 800-377-8721
Fax Number : 304-523-2241
Provider Business Practice Location Address
First Line : 388 YPAO RD
Second Line :
City : TAMUNING
State : GU
Zip : 96913-3701
Country : US
Telephone Number : 671-646-8881
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2006
Last Update Date : 07/01/2025

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