Individual
MR. PATRICK J WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
744 52ND ST, SUITE 5203, OAKLAND, CA 94609
(510) 428-3319
Mailing address
744 52ND ST, SUITE 5203, OAKLAND, CA 94609
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA-19625
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA19625
STATE MEDICAL LICESNE
CA
Enumeration date
02/21/2008
Last updated
07/22/2022
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