Healthcare Provider Details

I. General information

NPI: 1679015432
Provider Name (Legal Business Name): ERIC WONG CHIROPRACTIC, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2016
Last Update Date: 10/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

723 S. GARFIELD AVE SUITE 202
ALHAMBRA CA
91801
US

IV. Provider business mailing address

723 S. GARFIELD AVE SUITE 202
ALHAMBRA CA
91801
US

V. Phone/Fax

Practice location:
  • Phone: 415-935-3519
  • Fax:
Mailing address:
  • Phone: 626-888-1322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: DR. ERIC T WONG
Title or Position: PRESIDENT
Credential: D.C.
Phone: 415-935-3519