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General NPI Number Information
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NPI Number | 1972551174
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Entity Type | Organization
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Legal Business Name | PACIFIC ALLIANCE MEDICAL CENTER, INC
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 06/11/2013
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Provider Practice Location Address
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Address Line | 4837 HUNTINGTON DR N
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City | LOS ANGELES
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State | CA
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Zip | 90032-1953
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Country | US
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Telephone | 323-343-9460
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Fax | 323-343-9466
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Provider Business Mailing Address
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Address Line | 711 W COLLEGE ST 628
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City | LOS ANGELES
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State | CA
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Zip | 90012-1163
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Country | US
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Telephone | 213-830-8920
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Fax | 213-830-8925
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Authorized Official
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Title or Position | CHAIRMAN
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Name | DR. SHI-YIN WONG
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Credential | M.D
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Telephone | 213-830-8950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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