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General NPI Number Information
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NPI Number | 1851626808
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Entity Type | Organization
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Legal Business Name | LIAM WONG LLC
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Dates
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Enumeration Date | 10/08/2009
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Last Update Date | 10/08/2009
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Provider Practice Location Address
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Address Line | 350 WARD AVE # 106-138
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City | HONOLULU
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State | HI
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Zip | 96814-4010
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Country | US
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Telephone | 808-735-9093
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Fax |
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Provider Business Mailing Address
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Address Line | 350 WARD AVE # 106-138
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City | HONOLULU
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State | HI
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Zip | 96814-4010
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Country | US
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Telephone | 808-735-9093
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Fax |
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Authorized Official
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Title or Position | SOLE OWNER
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Name | LIAM WONG
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Credential | D.O.
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Telephone | 808-735-9093
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | DOS-1240
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License Number State | HI
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