Provider Demographics
NPI:1932286432
Name:GRACE KAR-YING WONG MD LLC
Entity Type:Organization
Organization Name:GRACE KAR-YING WONG MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:KAR-YING
Authorized Official - Last Name:OUCHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-522-7380
Mailing Address - Street 1:1329 LUSITANA ST
Mailing Address - Street 2:709
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2429
Mailing Address - Country:US
Mailing Address - Phone:808-522-7380
Mailing Address - Fax:808-522-7384
Practice Address - Street 1:1329 LUSITANA ST
Practice Address - Street 2:709
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2429
Practice Address - Country:US
Practice Address - Phone:808-522-7380
Practice Address - Fax:808-522-7384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2008-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-13477207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty