Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Granger B Wong M D Inc

Organization Plastic Surgery Physician · NPI 1609922962

Granger B Wong M D Inc is a Plastic Surgery Physician in Roseville, California. Licensed in California. Registered with an NPI since 2007.

Licensed in
CA
In the registry since
2007
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

576 N Sunrise Ave Ste 120
Roseville, CA 95661-2841
Phone: (916) 791-7088
Fax: (916) 791-7088
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Plastic Surgery Physician (primary) Taxonomy 208200000X · Licence A54333 (CA)

Record details

NPI number1609922962
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Granger Wong — President · (916) 791-7088
NPI enumeratedJanuary 26, 2007
Last updated in NPPESJuly 1, 2015
Mailing address576 N Sunrise Ave, Suite 120, Roseville, CA 95661-2841

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