Wong, Roberta L
Wong, Roberta L is an individual health care provider with primary practice located at 1300 Crane Street , Menlo Park CA 94025-4429. She recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as her primary health care specialty. Wong, Roberta L can be contacted via phone (650) 498-6500.Contact Information
Primary practice address
1300 Crane Street
Menlo Park CA 94025-4429
Phone: (650) 498-6500
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | G71404 | California |
Profile Details
| NPI number | 1053322453 |
|---|---|
| LBN Legal business name | Wong, Roberta L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 10th, 2006 |
| Last updated | Jan 19th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053322453 | NPPES |
| Other | MMM00087M | NHIC |
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