Organization
GARY KONG MD MPH INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY KONG M.D. (PRESIDENT)
(818) 563-1449
Entity
Organization
Contact information
Practice address
3808 W RIVERSIDE DR, #406, BURBANK, CA 91505-4325
(818) 563-1449
(818) 563-1049
Mailing address
10061 RIVERSIDE DR, #362, TOLUCA LAKE, CA 91602-2560
(818) 563-1449
(818) 563-1049
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
A51276
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A8320997
DRIVERS LICENSE
CA
Enumeration date
12/12/2011
Last updated
03/07/2023
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