Individual
DR. LI SHENG KONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 N BRENT ST, SUITE 201, VENTURA, CA 93003-2822
(805) 663-3330
(805) 663-3331
Mailing address
100 N BRENT ST, SUITE 201, VENTURA, CA 93003-2822
(805) 663-3330
(805) 663-3331
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
0101238893
VA
2086S0129X
Vascular Surgery Physician
Primary
A99886
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010242424
—
VA
05
—
010242452
—
VI
05
—
010242479
—
VA
05
—
010242487
—
VA
05
—
010242517
—
VA
05
—
010251877
—
VA
05
—
010252695
—
VA
Enumeration date
03/14/2006
Last updated
11/20/2019
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