Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | A89341 | CA |
NPI | 1437334232 |
---|---|
Provider Name | Dr. Micheline Joelle Wong |
First Address | Woodland Hills, CA 91367-6701 |
Second Address | Torrance, CA 90502-2004 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/12/2007 |
Last Update Date | 18/10/2021 |