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Individual
AMANDA WONG
Active
Individual
AMANDA WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2388
NV
363A00000X
Physician Assistant
PA59545
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA2388
NEVADA PA LICENSE
NV
01
—
PA59545
CALIFORNIA PA LICENSE
CA
Enumeration date
07/16/2019
Last updated
09/18/2024
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