Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC30750 | CA |
N | 111NI0013X | Independent Medical Examiner | DC 30750 | CA |
NPI | 1700038601 |
---|---|
Provider Name | Dr. Kenneth H Hong |
First Address | Colton, CA 92324-2249 |
Second Address | Colton, CA 92324-2249 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/10/2008 |
Last Update Date | 06/07/2011 |