Organization
GRANGER B WONG M D INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GRANGER WONG MD (PRESIDENT)
(916) 791-7088
Entity
Organization
Contact information
Practice address
576 N SUNRISE AVE, SUITE 120, ROSEVILLE, CA 95661-2841
(916) 791-7088
(916) 791-7088
Mailing address
576 N SUNRISE AVE, SUITE 120, ROSEVILLE, CA 95661-2841
(916) 791-7088
(916) 791-6606
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
A54333
CA
Other
Enumeration date
01/26/2007
Last updated
07/01/2015
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