MEDICARE: JAMES HONG R.EEG.T

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	2472E0500X	EEG Technician

General Provider Information

NPI Number	:	1962808030
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES HONG R.EEG.T

Provider Business Mailing Address
First Line	:	705 E BORCHARD AVE
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92707-1917
Country	:	US
Telephone Number	:	714-247-9080
Fax Number	:

Provider Business Practice Location Address
First Line	:	705 E BORCHARD AVE
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92707-1917
Country	:	US
Telephone Number	:	714-247-9080
Fax Number	:

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

Provider Enumeration Date	:	11/17/2014
Last Update Date	:	11/17/2014

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