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Individual
GRACE I WONG
Active
Individual
GRACE I WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD 432620
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101996474
—
PA
01
—
1659648384
NPI TYP 2
CA
Enumeration date
08/23/2007
Last updated
12/28/2023
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