KENNETH KAN TIN WONG MD NPI 1184628695

NPI Information

NPI: 1184628695
Provider Name: KENNETH KAN TIN WONG, MD
Classification: Radiology - 2085R0001X
Entity Type: Individual

Specialization: Radiation Oncology

PECOS Registration: Yes

Address:
1441 EASTLAKE AVE
LOS ANGELES, CA
ZIP 90089
Phone: (323) 865-3050
Get Directions

Kenneth Kan Tin Wong, MD is a radiation oncology radiology in Los Angeles, CA. The provider is a radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. Kenneth Kan Tin Wong, MD NPI is 1184628695. 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:

1441 EASTLAKE AVE
LOS ANGELES, CA
ZIP 90089-112
Phone: (323) 865-3050

The NPI 1184628695 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/13/2005 and was last updated on 3/8/2016.

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	2085R0001X	Radiology	Radiation Oncology	A70448	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	I07929	MEDICARE UPIN

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: 4/28/2024

NPI Synchronization or Removal

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