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NPI Code Detail

MEDICARE: KONG MENG VANG

MEDICARE: KONG MENG VANG
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
1374700000XTechnicianCA

General Provider Information

NPI Number : 1699331876
Entity Type Code : Individual
Provider Name (Legal Business Name) : KONG MENG VANG
Provider Business Mailing Address
First Line : 1208 9TH ST
Second Line :
City : MODESTO
State : CA
Zip : 95354-0713
Country : US
Telephone Number : 209-558-4464
Fax Number : 209-558-4450
Provider Business Practice Location Address
First Line : 1208 9TH ST
Second Line :
City : MODESTO
State : CA
Zip : 95354-0713
Country : US
Telephone Number : 209-558-4464
Fax Number : 209-558-4450
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2019
Last Update Date : 05/14/2019

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Directions to “ KONG MENG VANG ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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