Individual
DR. DOROTHY LAI PING WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1025 W 24TH ST, SUITE 26, YUMA, AZ 85364-8366
(928) 344-5455
(928) 344-5465
Mailing address
1025 W 24TH ST, SUITE 26, YUMA, AZ 85364-8366
(928) 344-5455
(928) 344-5465
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD22877
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110180845
RR MEDICARE
AZ
05
—
330085
—
AZ
01
—
860917930
TID
AZ
01
—
AZ0805637
BCBS AZ
AZ
01
—
MD22877
STATE LICENCE
AZ
Enumeration date
02/14/2006
Last updated
01/26/2012
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