Organization
ACTIVE LIFE MEDICAL CENTER
Active
Other names
Physicians Plus Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HARRY KEVIN WONG DC (MEDICAL DIRECTOR)
(650) 365-7775
Entity
Organization
Contact information
Practice address
1391 WOODSIDE RD, 200, REDWOOD CITY, CA 94061-3578
(650) 365-7775
(365) 365-7896
Mailing address
1391 WOODSIDE RD, 200, REDWOOD CITY, CA 94061-3578
(650) 365-7775
(365) 365-7896
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
14813
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14813
LICENSE
CA
01
—
A69755
LICENSE
CA
Enumeration date
04/10/2007
Last updated
10/09/2007
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