Provider Demographics
NPI:1194983163
Name:HONG, SUNG WOOK (LAC)
Entity type:Individual
Prefix:MR
First Name:SUNG
Middle Name:WOOK
Last Name:HONG
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:WILLIAM
Other - Middle Name:
Other - Last Name:HONG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:693 E REMINGTON DR
Mailing Address - Street 2:# A
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-1941
Mailing Address - Country:US
Mailing Address - Phone:408-720-1247
Mailing Address - Fax:408-720-1757
Practice Address - Street 1:693 E REMINGTON DR
Practice Address - Street 2:# A
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-1941
Practice Address - Country:US
Practice Address - Phone:408-720-1247
Practice Address - Fax:408-720-1757
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-27
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 11981171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC 11981OtherACUPUNCTURE BOARD