Provider Demographics
NPI:1194900498
Name:WONG, GILBERT C (MD)
Entity type:Individual
Prefix:DR
First Name:GILBERT
Middle Name:C
Last Name:WONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3895 W 7800 S
Mailing Address - Street 2:SUITE 202
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84088-5617
Mailing Address - Country:US
Mailing Address - Phone:801-948-4442
Mailing Address - Fax:
Practice Address - Street 1:3895 W 7800 S
Practice Address - Street 2:SUITE 202
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84088-5617
Practice Address - Country:US
Practice Address - Phone:801-948-4442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-04
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT6825165-1205207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology