NPI 1003404633

Ivan Wong, LMT

Practitioner Massage Therapist South Pasadena, CA

Practice location

Address: 2000 Via del Rey, South Pasadena, CA 91030-4146
Phone: (310) 866-6203

Registered specialties

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X Licence MST-000417 (CA)

Other Massage Therapist providers in California →

Registry record

NPI: 1003404633
Entity type: Individual
Sex (as registered): Male
NPI issued: 8 Jan 2021
Record last updated: 8 Jan 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.