Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | A111288 | CA |
NPI | 1003068420 |
---|---|
Provider Name | Dr. Christina W Wong |
First Address | Walnut Creek, CA 94597-2168 |
Second Address | Whittier, CA 90606-2500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2008 |
Last Update Date | 25/11/2019 |