Provider Demographics
NPI:1740481688
Name:HONG, CHAI YI (PHD)
Entity type:Individual
Prefix:PROF
First Name:CHAI YI
Middle Name:
Last Name:HONG
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:PROF
Other - First Name:CHESTER
Other - Middle Name:
Other - Last Name:HONG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:290 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:MILLBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94030-2508
Mailing Address - Country:US
Mailing Address - Phone:650-692-6828
Mailing Address - Fax:
Practice Address - Street 1:290 BROADWAY
Practice Address - Street 2:
Practice Address - City:MILLBRAE
Practice Address - State:CA
Practice Address - Zip Code:94030-2508
Practice Address - Country:US
Practice Address - Phone:650-692-6828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC4973171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist