Individual
KENNY WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
5300 MCCONNELL AVE, LOS ANGELES, CA 90066-7026
(415) 202-1258
Mailing address
5300 MCCONNELL AVE, LOS ANGELES, CA 90066-7026
Taxonomy
Speciality
Code
Description
License number
State
170300000X
Genetic Counselor (M.S.)
Primary
—
CA
Other
Enumeration date
06/14/2007
Last updated
07/08/2007
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