# SHI YIN WONG MD, A MEDICAL CORPORATION

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

## Provider details

- **NPI number:** 1619029964
- **Authorized official:** MR. SHI YIN WONG M.D (OWNER)
- **Authorized official phone:** (213) 626-3589

## Contact information

- **Practice address:** 407 W COLLEGE ST, LOS ANGELES, CA 90012-2313
- **Practice address phone:** (213) 626-3589
- **Practice address fax:** (213) 626-7868
- **Mailing address:** 407 W COLLEGE ST, LOS ANGELES, CA 90012-2313
- **Mailing address phone:** (213) 626-3589
- **Mailing address fax:** (213) 626-7868

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | G34772 | CA | Yes |

## Other

- **Enumeration date:** 01/17/2007
- **Last updated:** 11/16/2010