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Organization
TONI L LONG M D A MEDICAL CORPORATION
Active
Organization
TONI L LONG M D A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MONICA M WENZEL (BILLER)
(310) 915-9154
Entity
Organization
Contact information
Practice address
2020 SANTA MONICA BLVD STE 570, SANTA MONICA, CA 90404-2131
(310) 453-9289
(310) 453-2161
Mailing address
2020 SANTA MONICA BLVD STE 570, SANTA MONICA, CA 90404-2131
(310) 453-9289
(310) 453-2161
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
G65155
CA
Other
Enumeration date
11/12/2010
Last updated
11/12/2010
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