Provider Demographics
NPI:1245306745
Name:HONG, WILLIAM H (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:H
Last Name:HONG
Suffix:
Gender:M
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:PO BOX 1634
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90308-1634
Mailing Address - Country:US
Mailing Address - Phone:310-674-9710
Mailing Address - Fax:310-590-1030
Practice Address - Street 1:575 E HARDY ST
Practice Address - Street 2:SUITE 212
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-4026
Practice Address - Country:US
Practice Address - Phone:310-674-9710
Practice Address - Fax:310-590-1030
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2013-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA52579207R00000X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW16682OtherGROUP NUMBER
CA00A525790Medicaid
CAW16682OtherGROUP NUMBER
CA00A525790Medicaid