Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | A84001 | CA |
N | 111NI0900X | Internist | A84001 | CA |
Y | 207RA0201X | Internist - Allergy & Immunology | A84001 | CA |
NPI | 1043486863 |
---|---|
Provider Name | Dr. Yu Wong |
First Address | Palo Alto, CA 94304-1601 |
Second Address | Palo Alto, CA 94304-1601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2008 |
Last Update Date | 19/09/2018 |