Organization
DOROTHY L. P. WONG, MD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOROTHY LAI PING WONG M.D. (PRESIDENT)
(928) 344-5455
Entity
Organization
Contact information
Practice address
1025 W 24TH ST, SUITE 26, YUMA, AZ 85364-8366
(928) 344-5455
(928) 344-5465
Mailing address
1025 W 24TH ST, SUITE 26, YUMA, AZ 85364-8366
(928) 344-5455
(928) 344-5465
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
22877
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110180845
RAILROAD MEDICARE
AZ
05
—
330085
—
AZ
Enumeration date
08/28/2007
Last updated
01/25/2012
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