Individual
ELLEN WONG
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
23622 CALABASAS RD, STE 250, CALABASAS, CA 91302-1549
(818) 591-3435
Mailing address
23622 CALABASAS RD, STE 250, CALABASAS, CA 91302-1549
(818) 591-3435
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
G37201
CA
Other
Enumeration date
12/15/2005
Last updated
07/08/2007
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