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Organization

ANTONIO K ONG MD A MEDICAL CORPORATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ANTONIO KAYABAN ONG M.D. (PRESIDENT)
(626) 573-1160
Entity
Organization

Contact information

Practice address
3505 HART AVE, SUITE 202, ROSEMEAD, CA 91770-2061
(626) 573-1160
(626) 573-1162
Mailing address
3505 HART AVE, SUITE 202, ROSEMEAD, CA 91770-2061
(626) 573-1160
(626) 573-1162

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A36630
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A366300
CA
01
A36630
PRIVATE INSURANCE
CA
Enumeration date
09/28/2010
Last updated
03/19/2020
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