Provider Demographics
NPI:1154419406
Name:DENISE A HONER M.D. INC
Entity type:Organization
Organization Name:DENISE A HONER M.D. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:A
Authorized Official - Last Name:HONER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-460-4050
Mailing Address - Street 1:5111 GARFIELD ST
Mailing Address - Street 2:STE A
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91941-5103
Mailing Address - Country:US
Mailing Address - Phone:619-460-4050
Mailing Address - Fax:619-460-7441
Practice Address - Street 1:5111 GARFIELD ST
Practice Address - Street 2:STE A
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91941-5103
Practice Address - Country:US
Practice Address - Phone:619-460-4050
Practice Address - Fax:619-460-7441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG71222207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G712220Medicaid
F28675Medicare UPIN
CAG71222Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID NUMB