Individual
DR. GEORGE T WONG JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
632 W GIBSON RD, WOODLAND, CA 95695
(530) 666-1631
(530) 661-2410
Mailing address
632 W GIBSON RD, WOODLAND, CA 95695
(530) 666-1631
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
G32287
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G322870
BLUE SHIELD
CA
05
—
00G322870
—
CA
01
—
160018398
RR MEDICARE
CA
01
—
P00745244
MEDICARE RAILROAD CARRIER
CA
Enumeration date
06/30/2006
Last updated
03/04/2010
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