Provider Demographics
NPI:1518585447
Name:WONG, ALEXANDER F (PA)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:F
Last Name:WONG
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1300 GOODLETTE-FRANK RD N
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5243
Mailing Address - Country:US
Mailing Address - Phone:239-732-0044
Mailing Address - Fax:239-732-0094
Practice Address - Street 1:9710 BRIMHALL RD
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93312-2779
Practice Address - Country:US
Practice Address - Phone:618-296-7476
Practice Address - Fax:661-829-6937
Is Sole Proprietor?:No
Enumeration Date:2020-07-07
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9113307207N00000X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207N00000XAllopathic & Osteopathic PhysiciansDermatology