Individual
ETHAN BENJAMIN LUONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1800 N CALIFORNIA ST, STOCKTON, CA 95204-6019
(209) 547-7146
Mailing address
1800 N CALIFORNIA ST, STOCKTON, CA 95204-6019
(209) 547-7146
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A184728
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/24/2021
Last updated
08/25/2023
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