Nicole Sue Gong
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):