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NPI Code Detail

MEDICARE: MRS. VALERIE LEE WONG R.D.

MEDICARE:  MRS. VALERIE LEE WONG  R.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133VN1005XRenal Nutrition Registered Dietitian709327CA

General Provider Information

NPI Number : 1326004581
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. VALERIE LEE WONG R.D.
Provider Business Mailing Address
First Line : 2219 E SOLAR AVE
Second Line :
City : FRESNO
State : CA
Zip : 93720-4608
Country : US
Telephone Number : 559-324-4731
Fax Number : 559-324-4797
Provider Business Practice Location Address
First Line : 2755 HERNDON AVE
Second Line :
City : CLOVIS
State : CA
Zip : 93611-6800
Country : US
Telephone Number : 559-324-4000
Fax Number : 559-324-3748
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2006
Last Update Date : 08/07/2007

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Directions to “ MRS. VALERIE LEE WONG R.D.” Practice Location

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