Provider Demographics
NPI:1316038664
Name:CUI, HONG (MD)
Entity Type:Individual
Prefix:
First Name:HONG
Middle Name:
Last Name:CUI
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 1:2500 W UTOPIA RD STE 100
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-4172
Mailing Address - Country:US
Mailing Address - Phone:623-683-4462
Mailing Address - Fax:623-683-4963
Practice Address - Street 1:18404 N TATUM BLVD STE 101C
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-1511
Practice Address - Country:US
Practice Address - Phone:602-485-7475
Practice Address - Fax:602-485-7450
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ70393207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025024300Medicaid
AZ132913Medicaid
NE099471012OtherMEDICARE PTAN
NE10025024400Medicaid