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General NPI Number Information
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NPI Number | 1780703983
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Entity Type | Organization
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Legal Business Name | YEP H. WONG, M.D. INC
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 03/24/2015
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Provider Practice Location Address
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Address Line | 323 N PRAIRIE AVE # 334
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City | INGLEWOOD
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State | CA
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Zip | 90301-4502
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Country | US
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Telephone | 310-680-9300
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Fax | 310-672-1347
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Provider Business Mailing Address
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Address Line | 323 N PRAIRIE AVE # 334
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City | INGLEWOOD
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State | CA
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Zip | 90301-4502
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Country | US
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Telephone | 310-680-9300
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Fax | 310-672-1347
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Authorized Official
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Title or Position | PRESIDENT
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Name | YEP H WONG
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Credential | M.D.
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Telephone | 310-680-9300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | A14748
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License Number State | CA
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