Individual
VIVIAN WING-WAN WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
400 N PEPPER AVE, COLTON, CA 92324-1801
(704) 964-5729
Mailing address
25654 HURON ST, LOMA LINDA, CA 92354-3703
(704) 964-5729
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
81333
CA
Other
Enumeration date
05/01/2020
Last updated
05/01/2020
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