Provider Demographics
NPI:1881981520
Name:DONNA M HONG OD INC
Entity type:Organization
Organization Name:DONNA M HONG OD INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:HONG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:626-579-2020
Mailing Address - Street 1:10906 VALLEY MALL
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91731-2616
Mailing Address - Country:US
Mailing Address - Phone:626-579-2020
Mailing Address - Fax:626-444-8522
Practice Address - Street 1:10906 VALLEY MALL
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91731-2616
Practice Address - Country:US
Practice Address - Phone:626-579-2020
Practice Address - Fax:626-444-8522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-01
Last Update Date:2023-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13249T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5519040Medicaid
CA5519040Medicaid