| Doctor Name: | ELLEN WONG |
| NPI Number: | 1174509723 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | G37201 |
| Business Practice Address: | 23622 Calabasas Rd Ste 250 Calabasas, CA - 913021549 |
| Business Phone Number: | 8185913435 |
| Business Fax Number: | |
| Mailing Address: | 23622 Calabasas Rd, Ste 250 CALABASAS |
| State: | CA |
| Postal Code: | 913021549 |
| Phone Number: | 8185913435 |
| Fax Number: | |
| NPI Enumeration Date: | 12/15/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | G37201 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |