Provider Demographics
NPI:1689783292
Name:GEORGE HON MD A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:GEORGE HON MD A PROFESSIONAL CORPORATION
Other - Org Name:KIDNEY WELLNESS INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:G
Authorized Official - Last Name:HON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-424-2800
Mailing Address - Street 1:16415 COLORADO AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:PARAMOUNT
Mailing Address - State:CA
Mailing Address - Zip Code:90723-5051
Mailing Address - Country:US
Mailing Address - Phone:562-297-4120
Mailing Address - Fax:562-297-4008
Practice Address - Street 1:16415 COLORADO AVE STE 100
Practice Address - Street 2:
Practice Address - City:PARAMOUNT
Practice Address - State:CA
Practice Address - Zip Code:90723-5051
Practice Address - Country:US
Practice Address - Phone:562-297-4120
Practice Address - Fax:562-297-4008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG73910207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G739100MedicaidMEDICAID NUMBER
CA00G739100MedicaidMEDICAID NUMBER
CAG73910Medicare PIN