Michael C Wong MD Medical Corp

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

G34771 Issued in CA

Legal business name

MICHAEL C WONG MD MEDICAL CORP

Doing business as

California Womens Medical Clinic

Practice address

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

Phone

(858) 268-0300

Fax

(858) 268-3894

NPI assigned

May 2, 2007

Last updated

Nov 5, 2007By 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

Michael CHI Wai Wong, MDNPI 1033113600

Title

President

Phone

(858) 268-0300

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• California Womens Medical Clinic Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael C. Wong, MD

  • Obstetrics & Gynecology Physician
  • San Diego, CA
  • NPI 1033113600
  Authorized official Same address or phone
• Susan Luro Smith, RN, MSN, FNP

  • Family Nurse Practitioner
  • San Diego, CA
  • NPI 1447454038
  NPD (past)

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194220800000",
    "number": "1053532143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4282 GENESEE AVE",
            "address_2": "SUITE 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": "SUITE 201",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921174964",
            "telephone_number": "858-268-0300",
            "fax_number": "858-268-3894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL C WONG MD MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-02",
        "last_updated": "2007-11-05",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "CHI WAI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-268-0300",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "G34771",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0104370",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0104272",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0104271",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "California Womens Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Michael Gaspari Physical Therapy, P.C. (Tempered Strength PT)

• 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 Nov 5, 2007; 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.