Provider Demographics
NPI:1508182064
Name:WONG, WENDY (MD)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:
Last Name:WONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 MAJOR SHERMAN LN STE 305
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-4644
Mailing Address - Country:US
Mailing Address - Phone:831-718-8585
Mailing Address - Fax:831-901-3641
Practice Address - Street 1:910 MAJOR SHERMAN LN STE 305
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-4644
Practice Address - Country:US
Practice Address - Phone:831-718-8585
Practice Address - Fax:831-901-3641
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-08
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA118781208200000X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty