Provider Demographics
NPI:1639589435
Name:WONG, CONG-BONG BIU (OTD, OTR/L)
Entity Type:Individual
Prefix:DR
First Name:CONG-BONG
Middle Name:BIU
Last Name:WONG
Suffix:
Gender:M
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:946 E. NEWMARK AVE.
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91755-3102
Mailing Address - Country:US
Mailing Address - Phone:626-307-5830
Mailing Address - Fax:626-307-5830
Practice Address - Street 1:946 E. NEWMARK AVE.
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91755-3102
Practice Address - Country:US
Practice Address - Phone:626-307-5830
Practice Address - Fax:626-307-5830
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-01
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13102225XM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XM0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistMental Health