Individual
MR. HENRY MARK KWONG JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1750 E GLENDALE AVE, PHOENIX, AZ 85020-5505
(602) 242-4928
(602) 249-4813
Mailing address
1750 E GLENDALE AVE, PHOENIX, AZ 85020-5505
(602) 242-4928
(602) 249-4813
Taxonomy
Speciality
Code
Description
License number
State
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
36537
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
220709
—
AZ
Enumeration date
02/02/2007
Last updated
04/29/2020
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