Individual
SIDNEY LAKUSTA-WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2601 E ROOSEVELT ST, PHOENIX, AZ 85008-4973
(602) 344-5011
Mailing address
2929 E THOMAS RD, PHOENIX, AZ 85016-8034
(602) 470-5000
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
68487
AZ
208000000X
Pediatrics Physician
A163866
CA
Other
Enumeration date
05/11/2018
Last updated
02/24/2023
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