Individual
LESLIE WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3600 BROADWAY FL 3, OAKLAND, CA 94611-5730
(510) 752-6405
Mailing address
275 W MACARTHUR BLVD, OAKLAND, CA 94611-5641
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036-137084
IL
2086S0129X
Vascular Surgery Physician
Primary
148563
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/21/2010
Last updated
02/11/2022
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