Pong, Alice Louise

Pong, Alice Louise is an individual health care provider with primary practice located at 3020 Childrens Way , San Diego CA 92123-4223. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Infectious Diseases. Allopathic & Osteopathic Physicians / Pediatric Infectious Diseases is her primary health care specialty. Pong, Alice Louise can be contacted via phone (858) 966-7785.

Contact Information

Primary practice address
3020 Childrens Way San Diego CA 92123-4223
Phone: (858) 966-7785
Fax: (858) 966-8658
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X G75974 California
Allopathic & Osteopathic Physicians / Pediatric Infectious Diseases 2080P0208X G75974 California

Profile Details

NPI number 1568533313
LBN Legal business name Pong, Alice Louise
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 13th, 2006
Last updated Nov 3rd, 2011 - about 15 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 1568533313 NPPES
California MEDICAID 00G759740

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