Individual
THAI ON WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1045 ATLANTIC AVE STE 712, LONG BEACH, CA 90813-3411
(562) 491-4879
(562) 491-7987
Mailing address
1045 ATLANTIC AVE, SUITE 712, LONG BEACH, CA 90813-3411
(562) 491-4879
(562) 491-7987
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
20A15557
CA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
05/17/2012
Last updated
07/21/2022
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