Individual
DR. RAYMOND S WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MEDICAL DOCTOR
Contact information
Practice address
100 W CALIFORNIA BLVD, PASADENA, CA 91105-3010
(626) 397-5139
(626) 397-3409
Mailing address
223 N 1ST AVE, SUITE 201, ARCADIA, CA 91006-7089
(626) 821-1411
(626) 821-0406
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
G13482
CA
2085N0904X
Nuclear Radiology Physician
G13482
CA
2085R0202X
Diagnostic Radiology Physician
Primary
G13482
CA
2085R0204X
Vascular & Interventional Radiology Physician
G13482
CA
2085U0001X
Diagnostic Ultrasound Physician
G13482
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G134820
—
CA
Enumeration date
10/24/2005
Last updated
09/19/2007
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