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Individual

MERRY BETH GONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2344 6TH ST, BERKELEY, CA 94710-2412
(510) 981-3203
(510) 553-2169
Mailing address
3260 SACRAMENTO ST, BERKELEY, CA 94702-2739
(510) 601-6060
(510) 428-4594

Taxonomy

Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
G32302
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G323020
CA
01
ZZZ89670Z
PTAN
CA
Enumeration date
08/28/2006
Last updated
03/03/2014
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