Individual
DR. JASON T WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
24411 HEALTH CENTER DR, SUITE 350, LAGUNA HILLS, CA 92653-3651
(310) 923-4556
Mailing address
24411 HEALTH CENTER DR, SUITE 350, LAGUNA HILLS, CA 92653-3651
(310) 923-4556
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
227262
MA
208600000X
Surgery Physician
Primary
A113420
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2120917
—
MA
Enumeration date
04/26/2006
Last updated
09/10/2013
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