Organization
BERT KW WONG MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BERT KW WONG MD (OWNER)
(808) 526-0686
Entity
Organization
Contact information
Practice address
2228 LILIHA ST, SUITE 305, HONOLULU, HI 96817-1646
(808) 526-0686
(808) 526-0688
Mailing address
2228 LILIHA ST, SUITE 305, HONOLULU, HI 96817-1646
(808) 526-0686
(808) 526-0688
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
3694
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03062302
—
HI
01
—
C17149
HMSA
—
Enumeration date
04/16/2007
Last updated
05/05/2010
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