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Individual

MRS. THEODORA WONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD, RD

Contact information

Practice address
12801 CROSSROADS PKWY S, CITY OF INDUSTRY, CA 91746-3502
(562) 463-4357
Mailing address
13522 NEWPORT AVE STE 100, TUSTIN, CA 92780-3707
(626) 215-7996

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
1041101
208100000X
Physical Medicine & Rehabilitation Physician
Primary
A187282
CA

Other

Enumeration date
06/23/2017
Last updated
07/03/2025
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