Provider Demographics
NPI:1891855151
Name:JEONG, HOJOON (OMD)
Entity Type:Individual
Prefix:DR
First Name:HOJOON
Middle Name:
Last Name:JEONG
Suffix:
Gender:M
Credentials:OMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11330 HOLDER ST
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-5371
Mailing Address - Country:US
Mailing Address - Phone:714-903-1925
Mailing Address - Fax:
Practice Address - Street 1:9732 GARDEN GROVE BLVD STE 1
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92844-1624
Practice Address - Country:US
Practice Address - Phone:714-539-1665
Practice Address - Fax:714-539-1666
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC5133171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist