Individual
DR. GINA G. WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
10535 HOSPITAL WAY, 112 / I, MATHER, CA 95655-4200
(916) 366-5463
(916) 364-0187
Mailing address
5050 LAGUNA BLVD, SUITE 112, #411, ELK GROVE, CA 95758-4151
(832) 265-8467
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
11236T
CA
152W00000X
Optometrist
2689T
OR
152W00000X
Optometrist
5630T
TX
Other
Enumeration date
01/26/2006
Last updated
07/16/2007
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