Individual
GUSTAVO C. WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RDN, CDE, EP-C
Contact information
Practice address
1515 N SUNRISE WAY, PALM SPRINGS, CA 92262
(800) 720-9553
Mailing address
PO BOX 1384, RANCHO MIRAGE, CA 92270-1050
(760) 636-1408
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
08/08/2006
Last updated
06/12/2018
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