Provider Demographics
NPI:1689911844
Name:BE, RONG
Entity Type:Individual
Prefix:
First Name:RONG
Middle Name:
Last Name:BE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3530 ATLANTIC AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-4569
Mailing Address - Country:US
Mailing Address - Phone:562-424-1886
Mailing Address - Fax:562-424-2296
Practice Address - Street 1:3530 ATLANTIC AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-4569
Practice Address - Country:US
Practice Address - Phone:562-424-1886
Practice Address - Fax:562-424-2296
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-08
Last Update Date:2015-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No171M00000XOther Service ProvidersCase Manager/Care Coordinator