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General NPI Number Information
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NPI Number | 1295642767
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Entity Type | Individual
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Provider Name | KATRINA ZHENG GONG MD
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Gender | Female
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Dates
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Enumeration Date | 08/27/2026
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Last Update Date | 08/27/2026
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Provider Practice Location Address
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Address Line | 1011 BALDWIN PARK BLVD
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City | BALDWIN PARK
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State | CA
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Zip | 91706-5806
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Country | US
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Telephone | 626-851-1011
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Fax |
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Provider Business Mailing Address
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Address Line | 2658 GRIFFITH PARK BLVD # 197
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City | LOS ANGELES
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State | CA
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Zip | 90039-2520
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | C211240
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License Number State | CA
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