Provider Demographics
NPI:1063665115
Name:HONG, HWAL MIN (LAC)
Entity Type:Individual
Prefix:MR
First Name:HWAL MIN
Middle Name:
Last Name:HONG
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2756 SEPULVEDA BLVD
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-2952
Mailing Address - Country:US
Mailing Address - Phone:310-534-0058
Mailing Address - Fax:310-534-0058
Practice Address - Street 1:2756 SEPULVEDA BLVD
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-2952
Practice Address - Country:US
Practice Address - Phone:310-534-0058
Practice Address - Fax:310-534-0058
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-02
Last Update Date:2008-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 11149171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist