Individual
MELANIE M WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
5201 NORRIS CANYON RD STE 230, SAN RAMON, CA 94583-5405
(925) 939-8585
(925) 933-2709
Mailing address
PO BOX 31396, WALNUT CREEK, CA 94598-8396
(925) 939-8585
(925) 933-2709
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT29203
CA
2251X0800X
Orthopedic Physical Therapist
Primary
PT29203
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
EX714Z
MEDICARE PTAN
CA
Enumeration date
10/04/2006
Last updated
12/18/2020
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