Individual
SPENCER WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
9898 GENESEE AVE FL 3, LA JOLLA, CA 92037-1205
(858) 824-5363
Mailing address
10790 RANCHO BERNARDO RD, SAN DIEGO, CA 92127-5705
(858) 824-5363
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA61187
CA
Other
Enumeration date
03/21/2022
Last updated
06/21/2022
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