Individual
DR. DOUGLAS S WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7130 N MILLBROOK AVE, FRESNO, CA 93720-3347
(559) 450-5500
(559) 450-7473
Mailing address
1303 E HERNDON AVE, SUITE 431, FRESNO, CA 93720-3309
(559) 450-3889
(559) 450-7473
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G45487
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G454870
—
CA
Enumeration date
05/27/2005
Last updated
07/20/2015
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