| Tony Lee Wong, Md., Inc. | |
|
1800 Sullivan Ave Rm 104 Daly City CA 94015-2227 | |
| (650) 992-5300 | |
| (650) 992-5395 |
| Full Name | Tony Lee Wong, Md., Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1800 Sullivan Ave Rm 104, Daly City, California |
| Authorized Official Name and Position | Tony Lee Wong (PRESIDENT) |
| Authorized Official Contact | 6509925300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tony Lee Wong, Md., Inc. 1800 Sullivan Ave Rm 104 Daly City CA 94015-2227 Ph: (650) 992-5300 | Tony Lee Wong, Md., Inc. 1800 Sullivan Ave Rm 104 Daly City CA 94015-2227 Ph: (650) 992-5300 |
| NPI Number | 1548641939 |
|---|---|
| Provider Enumeration Date | 06/11/2015 |
| Last Update Date | 06/11/2015 |
| Medicare PECOS PAC ID | 1658414032 |
|---|---|
| Medicare Enrollment ID | O20100208000169 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548641939 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | A051262 (California) | Primary |
| Provider Name | Tony Wong |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831274422 PECOS PAC ID: 0244373611 Enrollment ID: I20100208000120 |
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