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NPI Code Detail

MEDICARE: DR. RAY DONG PC

MEDICARE: DR. RAY DONG PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1063080067
Entity Type Code : Organization
Provider Name (Legal Business Name) : DR. RAY DONG PC
Provider Business Mailing Address
First Line : 872 HUNTLEY DR
Second Line :
City : WEST HOLLYWOOD
State : CA
Zip : 90069-5002
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 872 HUNTLEY DR
Second Line :
City : WEST HOLLYWOOD
State : CA
Zip : 90069-5002
Country : US
Telephone Number : 424-402-9609
Fax Number :
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : DR. RAY DONG
Credential : MD
Telephone Number : 919-265-4957
Provider Enumeration Date : 06/15/2021
Last Update Date : 06/15/2021

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