Provider Demographics
NPI:1023203924
Name:HONG, YUHWAN (MD)
Entity Type:Individual
Prefix:MR
First Name:YUHWAN
Middle Name:
Last Name:HONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 K STREET
Mailing Address - Street 2:330
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816
Mailing Address - Country:US
Mailing Address - Phone:916-732-3000
Mailing Address - Fax:916-732-3023
Practice Address - Street 1:2801 K STREET
Practice Address - Street 2:330
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816
Practice Address - Country:US
Practice Address - Phone:916-732-3000
Practice Address - Fax:916-732-3023
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-13
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD65313207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAV111ZMedicare PIN