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General NPI Number Information
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NPI Number | 1356232383
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Entity Type | Individual
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Provider Name | LOK TIM ANGEL WONG MS, RDN, LDN, CDCES
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Gender | Female
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Dates
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Enumeration Date | 07/09/2025
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Last Update Date | 07/09/2025
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Provider Practice Location Address
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Address Line | 5761 S FORT APACHE RD
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City | LAS VEGAS
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State | NV
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Zip | 89148-5506
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Country | US
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Telephone | 702-341-6610
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Fax | 702-597-4750
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Provider Business Mailing Address
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Address Line | 4120 BROWNDEER CIR
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City | LAS VEGAS
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State | NV
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Zip | 89129-6560
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Country | US
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Telephone | 727-482-4403
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 39403-DI-3
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License Number State | NV
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