Provider Demographics
NPI:1134298185
Name:KUAN POK WONG M.D. INC.
Entity type:Organization
Organization Name:KUAN POK WONG M.D. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KUAN POK
Authorized Official - Middle Name:
Authorized Official - Last Name:WONG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-866-1764
Mailing Address - Street 1:10230 ARTESIA BLVD
Mailing Address - Street 2:#102
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-6763
Mailing Address - Country:US
Mailing Address - Phone:562-866-1764
Mailing Address - Fax:562-867-7123
Practice Address - Street 1:10230 ARTESIA BLVD
Practice Address - Street 2:#102
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-6763
Practice Address - Country:US
Practice Address - Phone:562-866-1764
Practice Address - Fax:562-867-7123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA26255261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care