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General NPI Number Information
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NPI Number | 1073900163
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Entity Type | Individual
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Provider Name | MORGAN WONG D.O.
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Gender | Male
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Dates
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Enumeration Date | 04/16/2015
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Last Update Date | 05/19/2022
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Provider Practice Location Address
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Address Line | 2331 MONTPELIER DR STE B
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City | SAN JOSE
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State | CA
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Zip | 95116-1673
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Country | US
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Telephone | 408-515-2428
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Fax | 408-347-9004
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Provider Business Mailing Address
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Address Line | 2331 MONTPELIER DR STE B
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City | SAN JOSE
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State | CA
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Zip | 95116-1673
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Country | US
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Telephone | 408-515-2428
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Fax | 408-347-9004
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | A-2504-21
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License Number State | NM
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