Organization
LOUIS & MARY JO WONG
Active
Organization
LOUIS & MARY JO WONG
Active
Other names
2010 PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOUIS TAI WAI WONG PHARM D (PARTNER)
(213) 483-5910
Entity
Organization
Contact information
Practice address
2200 W 3RD ST STE 390, LOS ANGELES, CA 90057-1932
(213) 483-5910
(213) 483-5913
Mailing address
2200 W 3RD ST STE 390, LOS ANGELES, CA 90057-1932
(213) 483-5910
(213) 483-5913
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
02889620001
CA
3336C0003X
Community/Retail Pharmacy
PHY30761
CA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174689715
—
CA
05
—
PHA307610
—
CA
05
—
PHY58007
—
CA
Enumeration date
12/28/2006
Last updated
01/29/2021
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