Most Relevant Information
Provider Data
| NPI Number: | 1003375007 |
| Provider Name: | ERIC RAY WONG DO |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/19/2019 |
| Last Updated: | 12/06/2021 |
Provider Practice Location
4733 W SUNSET BLVD FL 3
LOS ANGELES
CA
900276021
Practice Location Phone/Fax
| Phone: | 3237834516 |
| Fax: |
Provider Mailing Location
4733 W SUNSET BLVD FL 3
LOS ANGELES
CA
900276021
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |