Provider Demographics
NPI:1144070459
Name:REYNOLD WONG
Entity type:Organization
Organization Name:REYNOLD WONG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:DR
Authorized Official - First Name:REYNOLD
Authorized Official - Middle Name:SUI LUN
Authorized Official - Last Name:WONG
Authorized Official - Suffix:
Authorized Official - Credentials:DACM
Authorized Official - Phone:808-203-4677
Mailing Address - Street 1:2666 LILIHA ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-7344
Mailing Address - Country:US
Mailing Address - Phone:808-203-4677
Mailing Address - Fax:
Practice Address - Street 1:956 KAWAIAHAO ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814
Practice Address - Country:US
Practice Address - Phone:808-203-4677
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
No171400000XOther Service ProvidersHealth & Wellness CoachGroup - Multi-Specialty