Provider Demographics
NPI:1598181166
Name:ONG, KIAN LAM (MD)
Entity Type:Individual
Prefix:DR
First Name:KIAN
Middle Name:LAM
Last Name:ONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 SPRUCEWOOD
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-2117
Mailing Address - Country:US
Mailing Address - Phone:949-510-5442
Mailing Address - Fax:
Practice Address - Street 1:33 SPRUCEWOOD
Practice Address - Street 2:
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-2117
Practice Address - Country:US
Practice Address - Phone:949-510-5442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-06
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA 35096282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital