Kabongo, Martin L

Kabongo, Martin L is an individual health care provider with primary practice located at 2822 E Florence Ave , Huntington Park CA 90255-5749. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Kabongo, Martin L can be contacted via phone (323) 923-1900.

Contact Information

Primary practice address
2822 E Florence Ave Huntington Park CA 90255-5749
Phone: (323) 923-1900
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X A55012 California

Profile Details

NPI number 1033168810
LBN Legal business name Kabongo, Martin L
Credentials MD, APC
Entity Individual
Sole proprietor 1 No
Enumeration date May 9th, 2006
Last updated Sep 26th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033168810 NPPES
California MEDICAID 00A550120

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