Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 20A54160 | CA |
NPI | 1174733984 |
---|---|
Provider Name | Theresa Anna Maria Hong |
First Address | San Francisco, CA 94109-2549 |
Second Address | San Francisco, CA 94109-2549 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 08/07/2007 |