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Organization
THEA CENTER FOR REGENERATIVE MEDICINE
Active
Organization
THEA CENTER FOR REGENERATIVE MEDICINE
Active
Other names
Thea CRM, Thea Center for Regenerative Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOY KONG MD (MEDICAL DIRECTOR)
(310) 592-7504
Entity
Organization
Contact information
Practice address
9568 TOPANGA CANYON BLVD, CHATSWORTH, CA 91311-4011
(818) 356-8232
(818) 483-6262
Mailing address
9568 TOPANGA CANYON BLVD, CHATSWORTH, CA 91311-4011
(818) 356-8232
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
—
175F00000X
Naturopath
—
—
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
—
—
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
—
—
2084P0800X
Psychiatry Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
02/06/2021
Last updated
02/06/2021
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