Individual
MATTHEW K WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
4650 W SUNSET BLVD, LOS ANGELES, CA 90027-6062
(650) 520-6864
Mailing address
4650 W SUNSET BLVD, LOS ANGELES, CA 90027-6062
(650) 520-6864
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
717958
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
F382837
NY
Other
Enumeration date
07/21/2017
Last updated
07/12/2021
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