Individual
DR. GRANGER BRADFORD WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD,DMD,FACS
Contact information
Practice address
2221 STOCKTON BLVD, SACRAMENTO, CA 95817-1418
(916) 734-2130
Mailing address
2221 STOCKTON BLVD, SACRAMENTO, CA 95817-1418
(916) 734-2130
Taxonomy
Speciality
Code
Description
License number
State
170100000X
Ph.D. Medical Genetics
A54333
CA
208200000X
Plastic Surgery Physician
Primary
A54333
CA
Other
Enumeration date
12/07/2005
Last updated
03/10/2014
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