Individual
MR. KENT HON-WAH WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3621 FOREST GLENN DR, MODESTO, CA 95355-1339
(209) 521-9661
(209) 521-9307
Mailing address
3621 FOREST GLENN DR, MODESTO, CA 95355-1339
(209) 521-9661
(209) 521-9307
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
G78664
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1902828841
—
CA
Enumeration date
12/05/2005
Last updated
04/20/2016
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