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Individual
ALICE GONG
Active
Individual
ALICE GONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A133823
CA
208M00000X
Hospitalist Physician
Primary
A133823
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A133823
STATE LICENSE
CA
Enumeration date
02/24/2011
Last updated
02/18/2021
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