Dr THAI O WONG is a male medical professional, specializing in General Surgery. He graduated in 2011 from Lake Erie College Of Osteopathic Medicine.
GOLDEN STATE PROVIDERS, A MEDICAL CORPORATION
215 W JANSS RD
THOUSAND OAKS
CA
913601847
Tel: 7027318394
| Npi | 1427318955 |
| Pac Id | 7517246507 |
| Professional Enrollment Id | I20170724002291 |
| Last Name | WONG |
| First Name | THAI |
| Middle Name | O |
| Suffix | |
| Gender | M |
| Credential | |
| Medical School Name | LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE |
| Graduation Year | 2011 |
| Primary Specialty | GENERAL SURGERY |
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| Organization Legal Name | GOLDEN STATE PROVIDERS, A MEDICAL CORPORATION |
| Group Practice Pac Id | 7012212475 |
| Number Of Group Practice Members | 25 |
| Line 1 Street Address | 215 W JANSS RD |
| Line 2 Street Address | |
| Marker Of Address Line 2 Suppression | |
| City | THOUSAND OAKS |
| State | CA |
| Zip Code | 913601847 |
| Phone Number | 7027318394 |
| Hospital Affiliation Ccn 1 | 050549 |
| Hospital Affiliation Lbn 1 | LOS ROBLES HOSPITAL & MEDICAL CENTER |
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| Professional Accepts Medicare Assignment | Y |
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