Individual
BARRY WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O MPH
Contact information
Practice address
350 HAWTHORNE AVE, ROOM 2346, OAKLAND, CA 94609-3108
(510) 869-6883
(510) 869-6888
Mailing address
3687 MT DIABLO BLVD, SUITE 200, LAFAYETTE, CA 94549-3717
(916) 854-6975
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
20A14004
CA
208M00000X
Hospitalist Physician
Primary
20A14004
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20A14004
STATE LICENSE
CA
Enumeration date
11/21/2014
Last updated
07/21/2022
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