Provider Demographics
NPI:1457926230
Name:HONG, JAMES (LAC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:HONG
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2135 S HAMMATT PKWY
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92802-3940
Mailing Address - Country:US
Mailing Address - Phone:714-323-3562
Mailing Address - Fax:
Practice Address - Street 1:17541 IRVINE BLVD STE D
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3158
Practice Address - Country:US
Practice Address - Phone:657-900-2211
Practice Address - Fax:657-223-2316
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-24
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18098171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist