Healthcare Provider Details

I. General information

NPI: 1326509894
Provider Name (Legal Business Name): JOSEPH ISAAC SALIENTES WONG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2019
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4733 W SUNSET BLVD FL 3
LOS ANGELES CA
90027-6093
US

IV. Provider business mailing address

4733 W SUNSET BLVD FL 3
LOS ANGELES CA
90027-6093
US

V. Phone/Fax

Practice location:
  • Phone: 323-783-4516
  • Fax:
Mailing address:
  • Phone: 323-783-4516
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA179042
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA179042
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: