Provider Demographics
NPI:1831357573
Name:WONG, ALAN K (MD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:K
Last Name:WONG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 60790
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91116-6790
Mailing Address - Country:US
Mailing Address - Phone:626-795-6596
Mailing Address - Fax:626-795-8247
Practice Address - Street 1:501 S BUENA VISTA ST
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4809
Practice Address - Country:US
Practice Address - Phone:818-847-3935
Practice Address - Fax:818-843-8111
Is Sole Proprietor?:No
Enumeration Date:2008-05-29
Last Update Date:2015-08-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA95604207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A956040OtherBLUE SHIELD
CAAZ653ZMedicare PIN