Individual
MICHAEL C. WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4282 GENESEE AVE, STE 201, SAN DIEGO, CA 92117-4964
(858) 268-0300
(858) 268-3894
Mailing address
4282 GENESEE AVE, STE 201, SAN DIEGO, CA 92117-4964
(858) 268-0300
(858) 268-3894
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
G34771
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G347710
BLUESHIELD PROV ID
CA
05
—
00G347710
—
CA
Enumeration date
06/10/2005
Last updated
01/14/2008
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