Individual
ANITA WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1920 COLORADO AVE, 2ND FLOOR, SANTA MONICA, CA 90404-3414
(310) 319-4700
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A139775
CA
Other
Enumeration date
04/01/2014
Last updated
11/25/2019
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