Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | A63582 | CA |
NPI | 1023088630 |
---|---|
Provider Name | Dr. John J Hong |
First Address | Fallbrook, CA 92028-3081 |
Second Address | Fallbrook, CA 92028 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2006 |
Last Update Date | 06/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A635820 | (05) | CA |
GR0050840 | (05) | CA |
H54883 | (02) |