Individual
BRIAN WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1520 N MOUNTAIN AVE # E122, ONTARIO, CA 91762-1128
(909) 623-4484
(909) 623-4485
Mailing address
1520 N MOUNTAIN AVE # E122, ONTARIO, CA 91762-1128
(909) 623-4484
(909) 623-4485
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
5235
CA
Other
Enumeration date
05/08/2013
Last updated
11/19/2018
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