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General NPI Number Information
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NPI Number | 1619615234
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Entity Type | Individual
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Provider Name | LING FUNG KONG
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Gender | Male
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Dates
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Enumeration Date | 05/24/2022
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 11234 ANDERSON ST
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City | LOMA LINDA
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State | CA
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Zip | 92350-1716
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Country | US
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Telephone | 909-558-4918
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Fax |
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Provider Business Mailing Address
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Address Line | 11234 ANDERSON STREET, GME OFFICE UA-202
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City | LOMA LINDA
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State | CA
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Zip | 92350
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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 | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | 20A21890
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20A21890
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 2083A0300X
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Taxonomy Name | Addiction Medicine (Preventive Medicine) Physician
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License Number | 20A21890
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License Number State | CA
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