Provider Demographics
NPI:1336149616
Name:HON, ROXANNE AUDREY (MD INC)
Entity type:Individual
Prefix:
First Name:ROXANNE
Middle Name:AUDREY
Last Name:HON
Suffix:
Gender:F
Credentials:MD INC
Other - Prefix:
Other - First Name:ROXANNE
Other - Middle Name:AUDREY
Other - Last Name:HON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:8030 LA MESA BLVD
Mailing Address - Street 2:#143
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-0335
Mailing Address - Country:US
Mailing Address - Phone:619-697-7900
Mailing Address - Fax:619-462-6428
Practice Address - Street 1:8030 LA MESA BLVD
Practice Address - Street 2:#143
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-0335
Practice Address - Country:US
Practice Address - Phone:619-697-7900
Practice Address - Fax:619-462-6428
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-28
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA56292208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
G37811Medicare UPIN