Healthcare Provider Details

I. General information

NPI: 1326520404
Provider Name (Legal Business Name): FREDA HIO TONG LEI MSW STUDENT INTERN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2018
Last Update Date: 09/05/2018
Certification Date: LEI FREDA HIO TONG 11419 LAMBERT AVE EL MONTE CA 91732 600 ST PAUL AVE STE 101 LOS ANGELES CA 90017
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 ST PAUL AVE STE 101
LOS ANGELES CA
90017-5660
US

IV. Provider business mailing address

11419 LAMBERT AVE
EL MONTE CA
91732-1840
US

V. Phone/Fax

Practice location:
  • Phone: 213-483-3000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: