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Organization
PATRICK L S KONG M D A PROFESSIONAL CORPORATION
Active
Organization
PATRICK L S KONG M D A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRICK L S KONG MD (OWNER)
(805) 988-1105
Entity
Organization
Contact information
Practice address
1700 N ROSE AVE STE 450, OXNARD, CA 93030-7628
(805) 988-1105
(805) 988-1554
Mailing address
P.O. BOX 1540, CAMARILLO, CA 93011
(805) 988-1105
(805) 988-1554
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A043407
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A043407
LIC
CA
Enumeration date
09/14/2010
Last updated
09/17/2010
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