AMY WONG D.D.S. INC NPI 1063734036

NPI Information

AMY WONG D.D.S., INC is a point of service in San Gabriel, CA. The provider is this product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. AMY WONG D.D.S., INC NPI is 1063734036. The provider is registered as an organization entity type.

The provider's business location address is:

1404 S SAN GABRIEL BLVD STE A
SAN GABRIEL, CA
ZIP 91776-603
Phone: (626) 863-8578

The provider's authorized official is Amy Wong .
The authorized official title is President and has the following contact phone number (626) 863-8575.

The enumeration date for this NPI number is 2/18/2010 and was last updated on 11/2/2011.

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:

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