Healthcare Provider Details

I. General information

NPI: 1194412908
Provider Name (Legal Business Name): CHRISTINA WONG CO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2023
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 DELTA FAIR BLVD
ANTIOCH CA
94509-4004
US

IV. Provider business mailing address

9667 CAMASSIA WAY
SAN RAMON CA
94582-5263
US

V. Phone/Fax

Practice location:
  • Phone: 925-779-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberA205627
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: