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General NPI Number Information
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NPI Number | 1508045428
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Entity Type | Organization
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Legal Business Name | HING C. WONG
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Dates
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Enumeration Date | 10/27/2007
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Last Update Date | 08/20/2015
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Provider Practice Location Address
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Address Line | 709 N HILL ST STE 19
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City | LOS ANGELES
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State | CA
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Zip | 90012-2352
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Country | US
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Telephone | 213-628-7958
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Fax | 213-617-9731
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Provider Business Mailing Address
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Address Line | 709 N HILL ST STE 19
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City | LOS ANGELES
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State | CA
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Zip | 90012-2352
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Country | US
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Telephone | 213-628-7958
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Fax | 213-617-9731
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Authorized Official
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Title or Position | BILLER
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Name | NANCY TEA
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Credential |
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Telephone | 213-628-7958
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A308100
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License Number State | CA
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