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General NPI Number Information
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NPI Number | 1215386982
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Entity Type | Organization
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Legal Business Name | JAMES W. WONG, M.D., INC.
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Dates
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Enumeration Date | 06/03/2016
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Last Update Date | 06/03/2016
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Provider Practice Location Address
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Address Line | 500 N GARFIELD AVE SUITE 204
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City | MONTEREY PARK
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State | CA
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Zip | 91754-1242
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Country | US
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Telephone | 626-980-4393
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Fax |
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Provider Business Mailing Address
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Address Line | 1455 RUTHERFORD DR
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City | PASADENA
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State | CA
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Zip | 91103-2776
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Country | US
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Telephone | 626-641-3891
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAMES W WONG
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Credential | M.D.
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Telephone | 626-641-3891
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | A22857
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License Number State | CA
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