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Individual

CAROLINE WONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3838 SAN DIMAS ST, SUITE A100, BAKERSFIELD, CA 93301-2284
(661) 869-2600
(661) 869-2003
Mailing address
PO BOX 11959, BAKERSFIELD, CA 93389-3959
(661) 869-2600
(661) 869-2003

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
G75701
CA
208M00000X
Hospitalist Physician
G757011
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G757010
CA
05
00G757011
CA
01
P00379026
MEDICARE RAILROAD
Enumeration date
09/01/2006
Last updated
11/15/2007
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