Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | G51644 | CA |
NPI | 1104977008 |
---|---|
Provider Name | Dr. Stephen Curtis Wong |
First Address | Hacienda Heights, CA 91745-6813 |
Second Address | Hacienda Heights, CA 91745-6813 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2007 |
Last Update Date | 21/10/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E96424 | (02) | CA |