Individual
DR. TIN WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
711 W COLLEGE ST, LOS ANGELES, CA 90012-1163
(213) 625-3182
Mailing address
711 W COLLEGE ST STE 208, LOS ANGELES, CA 90012-1093
(213) 625-3182
(213) 625-1883
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
OT014708
PA
207QA0505X
Adult Medicine Physician
Primary
20A13729
CA
390200000X
Student in an Organized Health Care Education/Training Program
P13-00487
NJ
Other
Enumeration date
06/24/2012
Last updated
03/17/2018
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