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General NPI Number Information
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NPI Number | 1144524232
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Entity Type | Organization
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Legal Business Name | CURTIS SF WONG, MD, INC
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Dates
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Enumeration Date | 01/04/2011
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Last Update Date | 01/04/2011
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Provider Practice Location Address
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Address Line | 2440 SISTER MARY COLUMBA DR SUITE 200
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City | RED BLUFF
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State | CA
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Zip | 96080-4356
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Country | US
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Telephone | 530-690-2424
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Fax | 530-690-2426
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Provider Business Mailing Address
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Address Line | 2440 SISTER MARY COLUMBA DR SUITE 200
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City | RED BLUFF
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State | CA
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Zip | 96080-4356
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Country | US
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Telephone | 530-690-2424
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Fax | 530-690-2426
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CURTIS SF WONG
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Credential | MD
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Telephone | 530-690-2424
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | G74386
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License Number State | CA
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