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Organization
WU KONG-TAY MD INC
Active
Organization
WU KONG-TAY MD 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
1818 N ORANGE GROVE AVE, 200, POMONA, CA 91767-3028
(909) 622-6433
(909) 469-2524
Mailing address
1818 N ORANGE GROVE AVE, 200, POMONA, CA 91767-3028
(909) 622-6433
(909) 469-2524
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A305530
—
CA
05
—
GR0083540
—
CA
Enumeration date
06/11/2007
Last updated
06/13/2008
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