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Organization
KONG-TAY WU, M.D, INC
Active
Organization
KONG-TAY WU, M.D, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KONG-TAY WU M.D. (PRESIDENT)
(909) 622-6433
Entity
Organization
Contact information
Practice address
437 N CAMPUS AVE, ONTARIO, CA 91764-4229
(909) 622-6433
(909) 469-2524
Mailing address
1818 N ORANGE GROVE AVE, STE 200, POMONA, CA 91767-3028
(909) 988-8203
(909) 988-5006
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A30553
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0083540
—
CA
Enumeration date
07/30/2010
Last updated
07/30/2010
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