Individual
IVAN HO-BUN WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6815 NOBLE AVE, VAN NUYS, CA 91405-3796
(818) 901-6600
(818) 997-7826
Mailing address
6815 NOBLE AVE, VAN NUYS, CA 91405-3796
(818) 901-6600
(818) 997-7826
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A100539
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A100539
MEDICAL LICENSE
CA
Enumeration date
06/25/2008
Last updated
06/25/2008
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