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Individual

DR. IRA G. WONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
95 KIRKHAM ST, SAN FRANCISCO, CA 94143-0001
(415) 476-1442
(415) 502-2521
Mailing address
1635 DIVISADERO ST, SUITE 625, BOX 1821, SAN FRANCISCO, CA 94143-0001
(415) 476-4029
(415) 476-4150

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
G27700
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G277000
CA
Enumeration date
08/05/2006
Last updated
07/09/2007
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