Provider Demographics
NPI:1972610160
Name:WOO, HON (MD)
Entity type:Individual
Prefix:DR
First Name:HON
Middle Name:
Last Name:WOO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1516 COTNER AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-3303
Mailing Address - Country:US
Mailing Address - Phone:310-445-2951
Mailing Address - Fax:310-479-1459
Practice Address - Street 1:79 SCRIPPS DR STE 100
Practice Address - Street 2:DIAGNOSTIC RADIOLOGICAL IMAGING
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-6208
Practice Address - Country:US
Practice Address - Phone:916-921-1300
Practice Address - Fax:916-921-1095
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA606672085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A606670OtherBLUE SHIELD
CA00A606670Medicaid
CAG36410Medicare UPIN