Provider Demographics
NPI:1205908027
Name:GU, HONG (MD)
Entity type:Individual
Prefix:DR
First Name:HONG
Middle Name:
Last Name:GU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATHY
Other - Middle Name:HONG
Other - Last Name:GU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1800 HARRISON ST FL 7
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-3429
Mailing Address - Country:US
Mailing Address - Phone:510-625-6262
Mailing Address - Fax:
Practice Address - Street 1:555 CASTRO ST
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94041-2009
Practice Address - Country:US
Practice Address - Phone:650-903-2716
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA67285207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A672850Medicaid
00A672850Medicare PIN
H28851Medicare UPIN