# CONNIE WONG, DPM AND KI SANG YI, DPM INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346528908
- **Authorized official:** TIV BUNLEUTH (BILLING MANAGER)
- **Authorized official phone:** (562) 234-3174

## Contact information

- **Practice address:** 1703 TERMINO AVE, SUITE 103, LONG BEACH, CA 90804-2124
- **Practice address phone:** (562) 597-5100
- **Practice address fax:** (562) 597-5165
- **Mailing address:** 1703 TERMINO AVE, SUITE 103, LONG BEACH, CA 90804-2124
- **Mailing address phone:** (562) 597-5100
- **Mailing address fax:** (562) 597-5165

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | Yes |

## Other

- **Enumeration date:** 08/01/2011
- **Last updated:** 03/19/2020