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Individual
BARRY WONG
Active
Individual
BARRY WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O MPH
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
20A14004
CA
208M00000X
Hospitalist Physician
Primary
20A14004
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20A14004
STATE LICENSE
CA
Enumeration date
11/21/2014
Last updated
07/21/2022
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