MEDICARE: MS. ANNA MEI TING WONG OTR

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
1	225XH1200X	Hand Occupational Therapist	OT933A	CA

General Provider Information

NPI Number	:	1609089671
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANNA MEI TING WONG OTR

Provider Business Mailing Address
First Line	:	2504 HARGRAVE DR
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90068-2218
Country	:	US
Telephone Number	:	323-462-5809
Fax Number	:

Provider Business Practice Location Address
First Line	:	2504 HARGRAVE DR
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90068-2218
Country	:	US
Telephone Number	:	323-462-5809
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/07/2007
Last Update Date	:	11/17/2021

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