Provider Demographics
NPI:1598081978
Name:HONG, JAMIE GIHYUN (LAC,PHD)
Entity Type:Individual
Prefix:MS
First Name:JAMIE
Middle Name:GIHYUN
Last Name:HONG
Suffix:
Gender:F
Credentials:LAC,PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3030 W. OLYMPIC BLVD.,
Mailing Address - Street 2:SUITE 211
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90006
Mailing Address - Country:US
Mailing Address - Phone:213-364-0211
Mailing Address - Fax:
Practice Address - Street 1:3030 W. OLYMPIC BLVD.,
Practice Address - Street 2:SUITE 211
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006
Practice Address - Country:US
Practice Address - Phone:213-364-0211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-11
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC12436171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist