Organization
WC AND G
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN C WONG MD (PRESIDENT)
(415) 317-2945
Entity
Organization
Contact information
Practice address
233 W PORTAL AVE, SAN FRANCISCO, CA 94127-1401
(415) 317-2945
Mailing address
3436 FOOTHILL BLVD # 503, LA CRESCENTA, CA 91214-1826
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
G51644
CA
Other
Enumeration date
08/11/2009
Last updated
08/11/2009
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