Michael C. Wong, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

G34771 Issued in CA

Practice address

4282 Genesee Ave
Ste 201
San Diego, CA 92117-4964

Phone

(858) 268-0300

Fax

(858) 268-3894

NPI assigned

Jun 10, 2005

Last updated

Jan 14, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mwong683669@direct.umm.edu
• Direct secure messaging: mwong80503@scrippshlth.medalliesdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Michael C Wong MD Medical Corp

  dba California Womens Medical Clinic

  • Obstetrics & Gynecology Physician
  • San Diego, CA
  • NPI 1053532143
  Authorized official Same address or phone
• Scripps Health

  dba Scripps Hospital Medical Services

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1487928891
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200268800000",
    "number": "1033113600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4282 GENESEE AVE",
            "address_2": "STE 201",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921174964",
            "telephone_number": "858-268-0300",
            "fax_number": "858-268-3894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4282 GENESEE AVE",
            "address_2": "STE 201",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921174964",
            "telephone_number": "858-268-0300",
            "fax_number": "858-268-3894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "MICHAEL",
        "middle_name": "C.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-10",
        "last_updated": "2008-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "G34771",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G347710",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUESHIELD PROV ID",
            "identifier": "00G347710",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laurna Wong
• Lily Wong
• Maybelle Wong, PMHNP-BC
• Melinda Wong
• Melissa Akiko Wong, M.D.
• Nia Wong, M.S. LMFT
• Peter Wong, M.D.
• Rachel Wong
• Raymond Wong
• Seong Yeon Park Wong, MD

• Obstetrics & Gynecology Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Obstetrics & Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.