Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ivan Wong, LMT

Individual provider Massage Therapist · NPI 1003404633

Ivan Wong, LMT is a Massage Therapist in South Pasadena, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2021
What do these letters mean?
LMT — Licensed Massage Therapist
A state-licensed massage therapist.

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Practice location Address checks out

2000 Via Del Rey
South Pasadena, CA 91030-4146
Phone: (310) 866-6203
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Massage Therapist (primary) Taxonomy 225700000X · Licence MST-000417 (CA)

Record details

NPI number1003404633
Entity typeIndividual (Type 1)
GenderMale
Credentials LMT
Sole proprietorYes
NPI enumeratedJanuary 8, 2021
Last updated in NPPESJanuary 8, 2021
Certification dateJanuary 8, 2021
Mailing address2000 Via Del Rey, South Pasadena, CA 91030-4146

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