Individual
DR. THEODORE ALAN WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA, RN
Contact information
Practice address
1802 6TH AVE S, BIRMINGHAM, AL 35233-1932
(205) 934-3411
Mailing address
855 BRANNAN ST UNIT 677, SAN FRANCISCO, CA 94103-5276
(256) 527-1995
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95238443
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
134436
AL
Other
Enumeration date
04/29/2021
Last updated
02/11/2022
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