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Contact Information

RANDOLPH W WONG, MD
1501 TROUSDALE DR
5TH FLOOR
BURLINGAME, CA94010-4506
 Phone: 650-652-8787
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery

208600000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for RANDOLPH W WONG · (Male)

NPI # 1811038649
Status Active
Credentials MD
Entity Individual
Enumeration date 02/12/2007
Last updated 06/19/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • CA License # G76113
  • CA Medicaid YYY34803Y
  • CA Other G76113 LICENSE
Hospital affiliation(s)
  • PENINSULA MEDICAL CENTER - (Acute Care)
    1501 TROUSDALE DRIVE
    BURLINGAME, CA 94010
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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