Wong, Kalane Jade

Wong, Kalane Jade is an individual health care provider with primary practice located at 1017 2Nd St , Santa Rosa CA 95404-6608. She recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as her primary health care specialty. Wong, Kalane Jade can be contacted via phone (707) 546-9800.

Contact Information

Primary practice address
1017 2Nd St Santa Rosa CA 95404-6608
Phone: (707) 546-9800
Fax: (707) 546-4112
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X G62085 California

Profile Details

NPI number 1114905494
LBN Legal business name Wong, Kalane Jade
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 5th, 2006
Last updated Jun 20th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114905494 NPPES
Other P01035552 RAILROAD MEDICARE
MEDICAID 00G620850 RAILROAD MEDICARE

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