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General NPI Number Information
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NPI Number | 1902682842
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Entity Type | Organization
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Legal Business Name | ALICE WONG, DO, PC
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Dates
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Enumeration Date | 09/06/2023
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Last Update Date | 09/06/2023
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Provider Practice Location Address
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Address Line | 2215 ARTESIA BLVD #1683
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City | REDONDO BEACH
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State | CA
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Zip | 90278-6234
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Country | US
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Telephone | 213-419-0415
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Fax |
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Provider Business Mailing Address
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Address Line | 2215 ARTESIA BLVD #1683
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City | REDONDO BEACH
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State | CA
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Zip | 90278-6234
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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 | FOUNDER
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Name | ALICE WONG
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Credential | DO
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Telephone | 213-419-0415
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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