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General NPI Number Information
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NPI Number | 1962436428
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Entity Type | Individual
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Provider Name | KIN WONG MD
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Gender | Male
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 01/02/2013
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Provider Practice Location Address
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Address Line | 709 N HILL ST STE 8
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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 | 213-628-3300
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Fax | 213-625-2940
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Provider Business Mailing Address
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Address Line | 709 N HILL ST #8
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City | LOS ANGELES
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State | CA
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Zip | 90012
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Country | US
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Telephone | 213-628-3300
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Fax | 213-625-2940
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 20A7258
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License Number State | CA
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