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Nicole Sue Gong

  • Female

Medical Specialty

Professional ID

  • NPI: 1073037065
  • PECOS ID: 5395011936
  • Enrollment ID: I20171025003054
  • Credential(MD, DO, DPM):
  • Medical School:
  • Medical School Graduation Year: 2017

Medical Practices

  • Organization Name: Marin Physical Therapy Inc
  • Group Practice ID assigned by PECOS: 2466419189
  • Number of Group Practice member: 4

Location

  • Address1: 165 N Redwood Dr
  • Address2: Suite 120
  • City: San Rafael
  • State: California
  • Zip Code: 94903
  • Phone Number: (415)499-0278

Medicare

  • Medicare Assignment: Yes
  • Report Quality of Care to Physician Quality Reporting System (PQRS):
  • Used Electronic health record (EHR):