Individual
CHRISTINE WAI JUN WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
350 HAWTHORNE AVE RM 2346, OAKLAND, CA 94609-3108
(510) 869-6883
(510) 869-6888
Mailing address
325 DISTEL CIR, LOS ALTOS, CA 94022-1408
(510) 869-8670
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A121099
CA
208M00000X
Hospitalist Physician
Primary
A121099
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A121099
STATE LICENSE
CA
Enumeration date
04/21/2010
Last updated
03/10/2021
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