Individual
ELLEN NONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1500 DUARTE RD, DUARTE, CA 91010-3012
(800) 826-4673
Mailing address
PO BOX 512185, LOS ANGELES, CA 90051-0185
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
58461
CA
363A00000X
Physician Assistant
PA61372813
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1538772371
—
WA
Enumeration date
08/30/2020
Last updated
09/13/2024
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