Provider Demographics
NPI:1588690333
Name:HONG, JOUNGSEN (MD,FACG)
Entity type:Individual
Prefix:MR
First Name:JOUNGSEN
Middle Name:
Last Name:HONG
Suffix:
Gender:M
Credentials:MD,FACG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27725 PACHEA TRAIL
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92544-2545
Mailing Address - Country:US
Mailing Address - Phone:951-929-1177
Mailing Address - Fax:951-765-9111
Practice Address - Street 1:949 CALHOUN PL
Practice Address - Street 2:SUIT A
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-2545
Practice Address - Country:US
Practice Address - Phone:951-929-1177
Practice Address - Fax:951-765-9111
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA30075207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA3714222Medicaid
CA00A300750Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER