Active NPI
Kevin Q. Hong
- Pharmacist
- Lakeport, CA
National Provider Identifier
1366062317
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 81064
- Practice address
- 949 11TH St
Lakeport, CA 95453-4119 - Phone
- (707) 262-0244
- NPI assigned
- Apr 20, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 81064 | CA | Primary |
Addresses
Primary practice location
949 11TH St
Lakeport, CA 95453-4119
Mailing address
740 Big Dalton Ave
La Puente, CA 91746-1917
Phone (626) 482-4605
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 81064 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Longs Drug Store California LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pharmacy
- Kapolei, HI
- NPI 1700565793
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1587340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1587340800000",
"number": "1366062317",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "740 BIG DALTON AVE",
"city": "LA PUENTE",
"state": "CA",
"postal_code": "917461917",
"telephone_number": "626-482-4605"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "949 11TH ST",
"city": "LAKEPORT",
"state": "CA",
"postal_code": "954534119",
"telephone_number": "707-262-0244"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HONG",
"first_name": "KEVIN",
"middle_name": "Q.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-04-20",
"last_updated": "2020-04-20",
"certification_date": "2020-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "81064",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakeport, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.