Individual
THERESA WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
800 FAIRMOUNT AVE, PASADENA, CA 91105-3150
(626) 765-5636
Mailing address
621 CAMINO CERRADO, SOUTH PASADENA, CA 91030-4103
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
A159265
CA
Other
Enumeration date
03/30/2017
Last updated
05/11/2024
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