Individual
HUMBERTO WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 PASTEUR DR, STANFORD, CA 94305-2200
(650) 723-4000
Mailing address
300 PASTEUR DR, STANFORD, CA 94305-2200
(650) 723-4000
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A84419
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A844190
BLUE SHIELD
CA
05
—
00A844190
—
CA
Enumeration date
04/10/2007
Last updated
04/05/2024
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