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Individual

MRS. ANDREW C WONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
259 MERIDIAN AVE STE 15, SAN JOSE, CA 95126-2905
(408) 297-9852
(408) 297-9859
Mailing address
259 MERIDIAN AVE STE 15, SAN JOSE, CA 95126-2905
(408) 297-9852
(408) 297-9859

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
A52688
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A526881
CA
Enumeration date
07/17/2006
Last updated
07/08/2007
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