Provider Demographics
NPI:1720181399
Name:DO, HONG (MD)
Entity Type:Individual
Prefix:
First Name:HONG
Middle Name:
Last Name:DO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:991 MONTAGUE EXPY
Mailing Address - Street 2:STE 104
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-6809
Mailing Address - Country:US
Mailing Address - Phone:408-223-6073
Mailing Address - Fax:408-223-8030
Practice Address - Street 1:1692 TULLY ROAD
Practice Address - Street 2:SUITE #9
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95122
Practice Address - Country:US
Practice Address - Phone:408-223-6073
Practice Address - Fax:408-223-8030
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA41726207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0087117Medicaid
CA00A41726Medicare ID - Type Unspecified
CA0087117Medicaid