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NPI Code Detail

MEDICARE: CHUNG MAN WONG OTR/L

MEDICARE: CHUNG MAN WONG OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational TherapistOT10606CA

General Provider Information

NPI Number : 1336463991
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHUNG MAN WONG OTR/L
Provider Business Mailing Address
First Line : 2553 WHITEHORSE WAY
Second Line :
City : DUBLIN
State : CA
Zip : 94568-4611
Country : US
Telephone Number : 510-434-6440
Fax Number :
Provider Business Practice Location Address
First Line : 1805 WEST ST
Second Line :
City : HAYWARD
State : CA
Zip : 94545-1932
Country : US
Telephone Number : 510-783-4811
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2010
Last Update Date : 01/12/2015

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Directions to “ CHUNG MAN WONG OTR/L” Practice Location

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