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Individual

KELLEY K. WONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
11234 ANDERSON ST, LOMA LINDA, CA 92354-2804
(909) 558-4000
Mailing address
11234 ANDERSON ST, LOMA LINDA, CA 92354-2804
(909) 558-4000

Taxonomy

Speciality
Code
Description
License number
State
163WN0002X
Neonatal Intensive Care Registered Nurse
Primary
818137
CA

Other

Enumeration date
10/23/2017
Last updated
10/23/2017
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