Individual
JAMES RUSSELL HONGOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
830 SCENIC DR, SUITE B, MODESTO, CA 95350-6131
(209) 558-7000
Mailing address
830 SCENIC DR, MODESTO, CA 95350-6131
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A24239
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A242390
MEDICAL PROVIDER NUMBER
—
Enumeration date
07/21/2006
Last updated
07/31/2007
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