Provider Demographics
NPI:1760456768
Name:WONG, LIAM (DO, MPH)
Entity Type:Individual
Prefix:
First Name:LIAM
Middle Name:
Last Name:WONG
Suffix:
Gender:M
Credentials:DO, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 WARD AVE STE 106-138
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-4010
Mailing Address - Country:US
Mailing Address - Phone:808-783-7736
Mailing Address - Fax:
Practice Address - Street 1:350 WARD AVE STE 106-138
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-4010
Practice Address - Country:US
Practice Address - Phone:808-783-7736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-15
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A9039207L00000X
HI1240207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology