Amanda C. Wongsonegoro in Petaluma - Specialist
Amanda C. Wongsonegoro - NPI 1649480039
Amanda C. Wongsonegoro is a Specialist in Petaluma, California. Amanda C. Wongsonegoro practices all healthcare services and medical treatments related to Specialist. The NPI Number for Amanda C. Wongsonegoro is 1649480039. The last update date is 2007-07-08.
Amanda C. Wongsonegoro's current location address is 332 Keokuk St, Petaluma, California. You can contact this provider via phone number 7077624316 and fax number 7077624316. The mailing address for Amanda C. Wongsonegoro is 332 Keokuk St, Petaluma, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Amanda C. Wongsonegoro |
|---|---|
| Address | 332 Keokuk St, Petaluma, California |
| Phone Number | 7077624316 |
| Fax Number | 7077624316 |
| Sole Proprietor | Y |
| Credentials | CMT |
NPI Number Detail
| NPI Number | 1649480039 |
|---|---|
| Provider Enumeration Date | 2007-05-23 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 332 Keokuk St |
|---|---|
| City | Petaluma |
| State | California (CA) |
| Post Code | 949522729 |
| Phone Number | 7077624316 |
| Fax Number | 7077624316 |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
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Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
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What is the unique identifier code issued to Amanda C. Wongsonegoro by the Centers for Medicare & Medicaid Services?
The Amanda C. Wongsonegoro has been assigned the NPI (National Provider Identifier) 1649480039. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete physical address where Amanda C. Wongsonegoro is located?
The Amanda C. Wongsonegoro is situated at the following address: 332 Keokuk St, Petaluma, CA, 949522729.
What is the Amanda C. Wongsonegoro's area of specialization and corresponding taxonomy classification?
The Amanda C. Wongsonegoro's specialty field is Specialist, and it falls under the taxonomy code 174400000X, which categorizes healthcare providers based on their specialties.
When did the Amanda C. Wongsonegoro receive its 1649480039?
The Amanda C. Wongsonegoro was issued its 1649480039 on 2007-05-23, which is the date when the organization was assigned this unique identifier.
As of what date were the Amanda C. Wongsonegoro's details last updated?
The information pertaining to the Amanda C. Wongsonegoro, including its address, specialty, and other details, was most recently updated on 2007-07-08.