MEDICARE: BRIAN Y HONG D.D.S., M.S.

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
1	1223P0221X	Pediatric Dentistry	#37335	CA

General Provider Information

NPI Number	:	1528272093
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN Y HONG D.D.S., M.S.

Provider Business Mailing Address
First Line	:	2789 W OLYMPIC BLVD STE 301
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-2268
Country	:	US
Telephone Number	:	213-383-5437
Fax Number	:	213-383-5775

Provider Business Practice Location Address
First Line	:	2789 W OLYMPIC BLVD STE 301
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-2268
Country	:	US
Telephone Number	:	213-383-5437
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2007
Last Update Date	:	05/16/2022

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