Individual
JOHNSON WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
21001 N TATUM BLVD, PHOENIX, AZ 85050-4206
(480) 306-7832
Mailing address
21001 N TATUM BLVD, PHOENIX, AZ 85050-4206
(480) 306-7832
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
6358
AZ
Other
Enumeration date
01/02/2015
Last updated
05/12/2021
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