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General NPI Number Information
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NPI Number | 1295781979
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Entity Type | Individual
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Provider Name | PATRICIA W WONG MD
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Gender | Female
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Dates
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Enumeration Date | 05/25/2006
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Last Update Date | 03/08/2016
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Provider Practice Location Address
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Address Line | 1338 S HOPE ST
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City | LOS ANGELES
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State | CA
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Zip | 90015-2902
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Country | US
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Telephone | 213-742-5555
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Fax |
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Provider Business Mailing Address
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Address Line | 528 PALISADES DR UNIT 149
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City | PACIFIC PALISADES
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State | CA
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Zip | 90272-2844
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Country | US
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Telephone | 310-779-4534
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | A67231
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License Number State | CA
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