Individual
DR. GODFREY E WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1200 B GALE WILSON BLVD, FAIRFIELD, CA 94533-3552
(916) 481-0777
(916) 481-1881
Mailing address
P.O. BOX 66087, SACRAMENTO, CA 95866-0877
(916) 481-0777
(916) 481-1881
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
4301085094
MI
207L00000X
Anesthesiology Physician
Primary
A102650
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4771448
—
MI
05
—
4857874
—
MI
Enumeration date
03/01/2006
Last updated
02/09/2011
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