Provider Demographics
NPI:1174706410
Name:HONG, SEONG (RPH, PHD)
Entity type:Individual
Prefix:
First Name:SEONG
Middle Name:
Last Name:HONG
Suffix:
Gender:M
Credentials:RPH, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:988 S FAIR OAKS AVE # 250
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-2626
Mailing Address - Country:US
Mailing Address - Phone:626-799-6511
Mailing Address - Fax:626-799-6515
Practice Address - Street 1:988 S FAIR OAKS AVE # 250
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-2626
Practice Address - Country:US
Practice Address - Phone:626-799-6511
Practice Address - Fax:626-799-6515
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-10
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH57963183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist