Basic Information
| Provider Information | |||||||||
| NPI: | 1851626808 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LIAM WONG LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 350 WARD AVE # 106-138 | ||||||||
| Address2: | |||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968144010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8087359093 | ||||||||
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| Practice Location | |||||||||
| Address1: | 350 WARD AVE # 106-138 | ||||||||
| Address2: | |||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968144010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8087359093 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/08/2009 | ||||||||
| LastUpdateDate: | 10/08/2009 | ||||||||
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| AuthorizedOfficialLastName: | WONG | ||||||||
| AuthorizedOfficialFirstName: | LIAM | ||||||||
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| AuthorizedOfficialTitleorPosition: | SOLE OWNER | ||||||||
| AuthorizedOfficialTelephone: | 8087359093 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | D.O. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | DOS-1240 | HI | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.