Individual
FOOK Y WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
175 N JACKSON AVE, SUITE 104, SAN JOSE, CA 95116-1909
(408) 258-6566
(408) 258-6660
Mailing address
175 N JACKSON AVE, SUITE 104, SAN JOSE, CA 95116-1909
(408) 258-6566
(408) 258-6660
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
G66621
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G66621
CAL MD LICENSE #
CA
Enumeration date
12/14/2006
Last updated
07/09/2007
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