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General NPI Number Information
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NPI Number | 1104949866
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Entity Type | Organization
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Legal Business Name | F.K. MEDICAL GROUP
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Dates
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Enumeration Date | 04/09/2007
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Last Update Date | 07/23/2008
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Provider Practice Location Address
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Address Line | 7548 GARVEY AVE
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City | ROSEMEAD
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State | CA
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Zip | 91770-2960
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Country | US
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Telephone | 626-572-4103
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Fax | 626-572-0667
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Provider Business Mailing Address
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Address Line | 7548 GARVEY AVE
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City | ROSEMEAD
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State | CA
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Zip | 91770-2960
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Country | US
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Telephone | 626-572-4103
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Fax | 626-572-0667
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Authorized Official
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Title or Position | OWNER
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Name | DR. WAN KEI FONG
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Credential | LAC
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Telephone | 626-572-4103
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC 2221
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License Number State | CA
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