Individual
DR. DEREK ALAN WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10833 LECONTE AVE, MDCC 12-334, LOS ANGELES, CA 90095-1732
(310) 206-6581
(310) 206-8616
Mailing address
10833 LECONTE AVE, MDCC 12-334, LOS ANGELES, CA 90095-1732
(310) 206-6581
(310) 206-8616
Taxonomy
Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
G73118
CA
207SG0202X
Clinical Biochemical Genetics Physician
G73118
CA
208000000X
Pediatrics Physician
G73118
CA
Other
Enumeration date
01/24/2006
Last updated
01/09/2015
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