Individual ProviderErwin KongEmergency MedicineAllopathic & Osteopathic PhysiciansPractice Address4445 Magnolia Ave, Riverside, CA 92501-4135(510) 304-6700PECOS EnrollmentBased on the most recent information from CMS, provider Erwin Kong is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1174054043Provider TypeIndividualFull NameKong, ErwinGenderMaleSole ProprietorNoEnumeration Date3/22/2017Last Updated7/8/2020Contact InformationPractice LocationPractice Address4445 Magnolia Ave, Riverside, CA 92501-4135Phone(510) 304-6700FaxUnlisted FaxMailing LocationMailing Address500 Alexan Dr, Apt. 204, Durham, NC 27707-5930PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207P00000XPrimaryDescriptionEmergency MedicineAllopathic & Osteopathic PhysiciansLicenseA159563CaliforniaCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer