Individual
JEFFREY C.M. WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4643B WAIMEA CANYON DR., WAIMEA, HI 96796
(808) 338-8311
(808) 338-0225
Mailing address
4643B WAIMEA CANYON DR, WAIMEA, HI 96796
(808) 338-8311
(808) 338-0225
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
DOS-683
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
24873101
—
HI
01
—
49971600
QUEST ALOHACARE
—
01
—
518708
HMA
—
01
—
7100402
UHA
—
01
—
DOS683-01
MDX
—
01
—
G40180
KAISER
—
Enumeration date
11/30/2006
Last updated
07/08/2007
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