IVAN WONG LMT NPI 1003404633

NPI Information

NPI: 1003404633
Provider Name: IVAN WONG, LMT
Classification: Massage Therapist - 225700000X
Entity Type: Individual
Address:
2000 VIA DEL REY
SOUTH PASADENA, CA
ZIP 91030
Phone: (310) 866-6203
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Ivan Wong, LMT is a massage therapist in South Pasadena, CA. The provider is an individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. Ivan Wong, LMT NPI is 1003404633. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2000 VIA DEL REY
SOUTH PASADENA, CA
ZIP 91030-146
Phone: (310) 866-6203

The enumeration date for this NPI number is 1/8/2021 and was last updated on 1/8/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	225700000X	Massage Therapist		MST-000417	CALIFORNIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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