Provider Demographics
NPI:1407302748
Name:HONG, MYUNG HEE
Entity Type:Individual
Prefix:
First Name:MYUNG HEE
Middle Name:
Last Name:HONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 S LA FAYETTE PL.
Mailing Address - Street 2:#516
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057
Mailing Address - Country:US
Mailing Address - Phone:213-249-1567
Mailing Address - Fax:
Practice Address - Street 1:505 S LA FAYETTE PARK PL
Practice Address - Street 2:#516
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-1674
Practice Address - Country:US
Practice Address - Phone:213-249-1567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-28
Last Update Date:2016-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC16614171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist