Individual
DALE WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1422 HARRISON ST, OAKLAND, CA 94612-3903
(510) 809-1780
Mailing address
1422 HARRISON ST, OAKLAND, CA 94612-3903
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
95056331
CA
Other
Enumeration date
10/30/2017
Last updated
10/30/2017
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