Provider Demographics
NPI:1922287507
Name:HONG, RAYMOND S (LAC)
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:S
Last Name:HONG
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9007 TELEGRAPH RD
Mailing Address - Street 2:
Mailing Address - City:PICO RIVERA
Mailing Address - State:CA
Mailing Address - Zip Code:90660-5422
Mailing Address - Country:US
Mailing Address - Phone:323-533-8078
Mailing Address - Fax:
Practice Address - Street 1:9007 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:PICO RIVERA
Practice Address - State:CA
Practice Address - Zip Code:90660-5422
Practice Address - Country:US
Practice Address - Phone:323-533-8078
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-30
Last Update Date:2014-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 11768171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist