Healthcare Provider Details

I. General information

NPI: 1033351382
Provider Name (Legal Business Name): FRANCIS DOMINIC WONG D.O
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2009
Last Update Date: 03/21/2024
Certification Date: 03/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 HOSPITAL PKWY
SAN JOSE CA
95119-1103
US

IV. Provider business mailing address

275 HOSPITAL PKWY
SAN JOSE CA
95119-1106
US

V. Phone/Fax

Practice location:
  • Phone: 408-972-3000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number20A13370
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number20A13370
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: