Provider Demographics
NPI:1023159043
Name:WONG, RHEA LEE (MD)
Entity type:Individual
Prefix:DR
First Name:RHEA
Middle Name:LEE
Last Name:WONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2882 W CROMWELL AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-0353
Mailing Address - Country:US
Mailing Address - Phone:559-449-8460
Mailing Address - Fax:
Practice Address - Street 1:1140 T ST
Practice Address - Street 2:EMPLOYEE HEALTH
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93721-1413
Practice Address - Country:US
Practice Address - Phone:559-459-6414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG0451122083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine