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Individual

MS. GRACE MI CHONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
11301 WILSHIRE BLVD BLDG 215, LOS ANGELES, CA 90073-1003
(310) 478-3711
Mailing address
11301 WILSHIRE BLVD BLDG 215, LOS ANGELES, CA 90073-1003
(310) 478-3711

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
23397
CA

Other

Enumeration date
01/17/2014
Last updated
08/11/2014
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