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NPI Code Detail

MEDICARE: PUIMAN VONG

MEDICARE: PUIMAN VONG
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1386772911
Entity Type Code : Individual
Provider Name (Legal Business Name) : PUIMAN VONG
Provider Business Mailing Address
First Line : 11429 VALLEY BLVD
Second Line :
City : EL MONTE
State : CA
Zip : 91731-3229
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11429 VALLEY BLVD
Second Line :
City : EL MONTE
State : CA
Zip : 91731-3229
Country : US
Telephone Number : 626-442-8391
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2007
Last Update Date : 07/08/2007

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Directions to “ PUIMAN VONG ” Practice Location

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