Provider Demographics
NPI:1053578161
Name:HOYMAN HONG, MD A PROF MED CORP
Entity type:Organization
Organization Name:HOYMAN HONG, MD A PROF MED CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HOYMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HONG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-797-2453
Mailing Address - Street 1:34 N SAN MATEO DR
Mailing Address - Street 2:SUITE #2
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94401-2824
Mailing Address - Country:US
Mailing Address - Phone:650-513-6651
Mailing Address - Fax:650-350-4395
Practice Address - Street 1:1199 BUSH ST
Practice Address - Street 2:300
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-5999
Practice Address - Country:US
Practice Address - Phone:415-353-6464
Practice Address - Fax:415-353-6462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-19
Last Update Date:2013-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA681612081P2900X, 2081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty
No2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH59158Medicare UPIN