Individual
SAMANTHA WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15503 VENTURA BLVD STE 170, ENCINO, CA 91436-3145
(818) 461-8148
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
(310) 301-8732
(310) 301-8751
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
A134675
CA
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
A134675
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
CA
Other
Enumeration date
04/03/2013
Last updated
01/02/2019
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