Provider Demographics
NPI:1487345336
Name:HONG, SOJEONG
Entity type:Individual
Prefix:
First Name:SOJEONG
Middle Name:
Last Name:HONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1251 S BEACH BLVD STE F
Mailing Address - Street 2:
Mailing Address - City:LA HABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631-6397
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1251 S BEACH BLVD STE F
Practice Address - Street 2:
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631-6397
Practice Address - Country:US
Practice Address - Phone:562-448-0404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-19
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA201110156FC0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No156FC0801XEye and Vision Services ProvidersTechnician/TechnologistContact Lens Fitter