MEDICARE: CLIFFORD WONG MD

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
1	207RN0300X	Nephrology Physician	A68265	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780621706
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLIFFORD WONG MD

Provider Business Mailing Address
First Line	:	27200 CALAROGA AVE
Second Line	:
City	:	HAYWARD
State	:	CA
Zip	:	94545-4339
Country	:	US
Telephone Number	:	510-783-2003
Fax Number	:	510-783-2007

Provider Business Practice Location Address
First Line	:	27200 CALAROGA AVE
Second Line	:
City	:	HAYWARD
State	:	CA
Zip	:	94545-4339
Country	:	US
Telephone Number	:	510-783-2003
Fax Number	:	510-783-2007

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2006
Last Update Date	:	11/28/2022

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Directions to “ CLIFFORD WONG MD” Practice Location

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