Provider Demographics
NPI:1366027757
Name:HONG, KIOK
Entity Type:Individual
Prefix:MR
First Name:KIOK
Middle Name:
Last Name:HONG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8600 BEACH BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90620-5201
Mailing Address - Country:US
Mailing Address - Phone:714-821-9688
Mailing Address - Fax:714-821-9618
Practice Address - Street 1:8600 BEACH BLVD STE 104
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90620-5201
Practice Address - Country:US
Practice Address - Phone:714-821-9688
Practice Address - Fax:714-821-9618
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-17
Last Update Date:2022-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19064171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA19064OtherCALIFORNIA ACUPUNCTURE BOARD