Individual
GLENN WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2850 COMMERCIAL XING, SANTA CRUZ, CA 95065-1702
(831) 460-7355
Mailing address
2025 SOQUEL AVE, SANTA CRUZ, CA 95062-1323
(831) 479-6603
(831) 458-6293
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
20A10095
CA
Other
Enumeration date
03/20/2007
Last updated
11/04/2011
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