Individual
DR. GREGORY SAN WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1700 CESAR CHAVEZ AVE, SENIOR CARE CLINIC, LOS ANGELES, CA 90033-2414
(323) 307-0800
(323) 307-0803
Mailing address
1700 CESAR CHAVEZ AVE #3900, LOS ANGELES, CA 90033-2414
(323) 307-0800
(323) 307-0803
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
A96833
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A968330
—
CA
Enumeration date
01/24/2007
Last updated
10/01/2009
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