Individual
BRANDON WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
121 BARBOZA ST, MENDOTA, CA 93640-1901
(559) 655-5000
Mailing address
3875 W BEECHWOOD AVE, FRESNO, CA 93711-0795
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
58085
CA
Other
Enumeration date
05/16/2020
Last updated
10/16/2020
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