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General NPI Number Information
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NPI Number | 1164172631
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Entity Type | Individual
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Provider Name | SPENCER WONG
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Gender | Male
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Dates
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Enumeration Date | 03/26/2022
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 300 PASTEUR DR
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City | PALO ALTO
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State | CA
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Zip | 94305-2200
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Country | US
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Telephone | 650-723-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 378 PORT ROYAL AVE
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City | FOSTER CITY
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State | CA
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Zip | 94404-3535
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Country | US
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Telephone | 800-607-6377
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Fax |
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 95002725
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License Number State | CA
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