Individual
ALICE WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MT-BC
Contact information
Practice address
1550 FRONTERA WAY, #312, MILLBRAE, CA 94030-2801
(415) 710-3887
Mailing address
1550 FRONTERA WAY, #312, MILLBRAE, CA 94030-2801
(415) 710-3887
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
046444
PA
Other
Enumeration date
03/27/2012
Last updated
03/27/2012
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