Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | A68891 | CA |
NPI | 1225173099 |
---|---|
Provider Name | Dr. Wendy Bick-Ling Wong |
First Address | Mountain View, CA 94040-6203 |
Second Address | San Jose, CA 95124-4105 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2007 |
Last Update Date | 07/07/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A688910 | (05) | CA |
H94697 | (02) | CA |