Individual
KATRINA WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
6170 N DURANGO DR STE 130, LAS VEGAS, NV 89149-3923
(702) 940-1550
(702) 940-1551
Mailing address
6355 S BUFFALO DR FL 3, LAS VEGAS, NV 89113-2133
(702) 216-3346
(702) 671-6883
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO3500
NV
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1275161986
—
NV
01
—
DO3500
STATE LICENSE
NV
Enumeration date
03/29/2020
Last updated
10/02/2023
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