Doctor Name: | ANTHONY C. WONG |
NPI Number: | 1629020474 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | G69842 |
Business Practice Address: | 1848 Saratoga Ave Bldg. 2 Saratoga, CA - 950706612 |
Business Phone Number: | 4083702828 |
Business Fax Number: | 4083702800 |
Mailing Address: | Po Box 3387, SARATOGA |
State: | CA |
Postal Code: | 950701387 |
Phone Number: | 4083702828 |
Fax Number: | 4083702800 |
NPI Enumeration Date: | 05/17/2006 |
NPI Last Update Date: | 12/04/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | G69842 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |