Provider Demographics
NPI:1205904562
Name:WONG, ALAN KW (PT)
Entity type:Individual
Prefix:MR
First Name:ALAN
Middle Name:KW
Last Name:WONG
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:826 SOUTH KING STREET
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-3009
Mailing Address - Country:US
Mailing Address - Phone:808-523-9043
Mailing Address - Fax:808-526-0673
Practice Address - Street 1:94810 MOLOALO STREET
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-3355
Practice Address - Country:US
Practice Address - Phone:808-671-1711
Practice Address - Fax:808-671-1705
Is Sole Proprietor?:No
Enumeration Date:2006-12-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT867225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist