Provider Demographics
NPI:1669486312
Name:RO, HONGIK J (MD)
Entity Type:Individual
Prefix:
First Name:HONGIK
Middle Name:J
Last Name:RO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1902 ROYALTY DR
Mailing Address - Street 2:SUITE 220
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91767-3030
Mailing Address - Country:US
Mailing Address - Phone:909-620-8180
Mailing Address - Fax:909-469-6741
Practice Address - Street 1:1902 ROYALTY DR
Practice Address - Street 2:SUITE 220
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-3030
Practice Address - Country:US
Practice Address - Phone:909-620-8180
Practice Address - Fax:909-469-6741
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA365462085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A365460Medicare ID - Type Unspecified
CAA88383Medicare UPIN