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Individual

DR. KHOA CONG LUONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
4755 DOHENY DR, CHINO, CA 91710-4030
(909) 591-0051
Mailing address
27300 IRIS AVE, MORENO VALLEY, CA 92555-4802
(951) 243-2018

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
20A7838
CA
207P00000X
Emergency Medicine Physician
Primary
5101013560
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00AX78380
CA
05
3332971
MI
Enumeration date
11/23/2005
Last updated
11/17/2021
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