Individual
MS. ELISA NEREZ WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.S., PA-C
Contact information
Practice address
3650 MISSION AVE, SUITE 1, CARMICHAEL, CA 95608-2933
(916) 972-0882
(916) 972-0649
Mailing address
3650 MISSION AVE, SUITE 1, CARMICHAEL, CA 95608-2933
(916) 972-0882
(916) 972-0649
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA 15291
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G349230
BLUE SHIELD
CA
Enumeration date
04/21/2006
Last updated
01/28/2008
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