Individual
KONG MENG VANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1208 9TH ST, MODESTO, CA 95354-0713
(209) 558-4464
(209) 558-4450
Mailing address
1208 9TH ST, MODESTO, CA 95354-0713
(209) 558-4464
(209) 558-4450
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
—
CA
Other
Enumeration date
05/14/2019
Last updated
05/14/2019
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