Alice Wong, MT-BC

NPI #1598031254 in Millbrae, California

Provider Information

NPI Number: 1598031254
Entity Type: Individual
Name: Alice Wong, MT-BC
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Credential: MT-BC
Enumeration Date: Mar 27, 2012
Last Updated: Mar 27, 2012

Practice Location

Address: 1550 FRONTERA WAY
Address 2: #312
City: Millbrae
State: California
ZIP Code: 94030-2801
Phone: (415) 710-3887

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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