Organization
CHEST MEDICINE AND CRITICAL CARE MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVIES Y. WONG MD (PRESIDENT)
(858) 650-5036
Entity
Organization
Contact information
Practice address
7910 FROST STREET, SUITE 245, SAN DIEGO, CA 92123
(858) 650-5036
(858) 650-5039
Mailing address
7910 FROST STREET, SUITE 245, SAN DIEGO, CA 92123
(858) 650-5036
(858) 650-5039
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
207RP1001X
Pulmonary Disease Physician
Primary
—
—
208M00000X
Hospitalist Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0041490
—
CA
01
—
W10812
MEDICARE PTAN
CA
Enumeration date
08/12/2005
Last updated
08/18/2014
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