Organization
CALVIN K. WONG, MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CALVIN K. WONG MD (PRESIDENT)
(858) 571-0606
Entity
Organization
Contact information
Practice address
5471 KEARNY VILLA RD, SUITE 200, SAN DIEGO, CA 92123-1143
(858) 571-0606
(858) 571-1933
Mailing address
5471 KEARNY VILLA RD, SUITE 200, SAN DIEGO, CA 92123-1143
(858) 571-0606
(858) 571-1933
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G79819
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G79819
MEDICARE GROUP NUMBER
—
01
—
WG79819C
MEDICARE PROVIDER ID
—
Enumeration date
04/18/2007
Last updated
04/19/2010
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