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1114248218
ANGE MONG LY
GRESHAM, OR
NPI
1114248218
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: OR MD160078)
Enumeration Date
2010-06-13
Last Update Date
2013-07-05
Business Address
ANGE MONG LY M.D.
24800 SE STARK ST
GRESHAM, OR 97030-3378
Phone number: 503-674-1122
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Mailing Address
ANGE MONG LY M.D.
24800 SE STARK ST
GRESHAM, OR 97030-3378
Phone number: 503-674-1122
Copy
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