Cedric L Wong MD Inc

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

G74697 Issued in CA

Legal business name

CEDRIC L WONG MD INC

Practice address

1580 Creekside Drive
Suite 100
Folsom, CA 95630

Phone

(916) 984-4500

Fax

(916) 984-4502

NPI assigned

Jan 8, 2008

Last updated

Jan 8, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Cedric L Wong, MD

Title

President

Phone

(916) 984-4500

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1199750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199750400000",
    "number": "1033394168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 CREEKSIDE DRIVE",
            "address_2": "SUITE 100",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "95630",
            "telephone_number": "916-984-4500",
            "fax_number": "916-984-4502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 CREEKSIDE DRIVE",
            "address_2": "SUITE 100",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "95630",
            "telephone_number": "916-984-4500",
            "fax_number": "916-984-4502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDRIC L WONG MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-08",
        "last_updated": "2008-01-08",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "CEDRIC",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-984-4500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "G74697",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7242936",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Providers in Folsom, CA by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.