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General NPI Number Information
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NPI Number | 1619867231
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Entity Type | Organization
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Legal Business Name | ANDROMEDA WELLNESS & CHIROPRACTIC, WONG CORP
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Dates
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Enumeration Date | 07/07/2025
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Last Update Date | 02/06/2026
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Provider Practice Location Address
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Address Line | 2311 N TRACY BLVD FL 1
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City | TRACY
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State | CA
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Zip | 95376-2426
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Country | US
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Telephone | 702-372-8597
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 232
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City | FRENCH CAMP
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State | CA
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Zip | 95231-0232
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Country | US
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Telephone | 925-839-4673
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KATE WONG
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Credential | DC
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Telephone | 702-372-8597
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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