Individual
DR. SUSIE YIN-PENG WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
18617 GALE AVE, CITY OF INDUSTRY, CA 91748-1342
(626) 912-1871
(626) 912-6766
Mailing address
18617 GALE AVE, CITY OF INDUSTRY, CA 91748-1342
(626) 912-1871
(626) 912-6766
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
C042888
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C428880
—
CA
Enumeration date
07/04/2006
Last updated
04/18/2012
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