Individual
CAROLE GONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
719 SANTA MONICA BLVD, SANTA MONICA, CA 90401-2601
(310) 260-9039
Mailing address
1301 VIA DEL REY, SOUTH PASADENA, CA 91030-3630
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
298711
CA
Other
Enumeration date
08/12/2020
Last updated
08/12/2020
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