Provider Demographics
NPI:1407842149
Name:ONG, HUNG V (MD)
Entity Type:Individual
Prefix:DR
First Name:HUNG
Middle Name:V
Last Name:ONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:495 OLD NEWPORT BLVD
Mailing Address - Street 2:# 200
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-4210
Mailing Address - Country:US
Mailing Address - Phone:949-646-7546
Mailing Address - Fax:949-646-7556
Practice Address - Street 1:495 OLD NEWPORT BLVD
Practice Address - Street 2:# 200
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-4210
Practice Address - Country:US
Practice Address - Phone:949-646-7546
Practice Address - Fax:949-646-7556
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG72989207N00000X, 207ND0101X, 207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWG72989FMedicare PIN
G15035Medicare UPIN