Individual
BREANE WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1706 EL CAMINO REAL STE 101, MENLO PARK, CA 94027-4127
(650) 325-1395
Mailing address
675 SHARON PARK DR APT 321, MENLO PARK, CA 94025-6911
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA57180
CA
Other
Enumeration date
09/17/2019
Last updated
05/01/2020
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