NPIMap

Organization Active NPI

Julie Wong'S Proactive Clinic

  • Specialist
  • San Francisco, CA
National Provider Identifier
1083871271
Registry record updated May 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
0PT101670 Issued in CA
Legal business name
JULIE WONG'S PROACTIVE CLINIC
Practice address
1489 Webster St
Suite 210
San Francisco, CA 94115-3766
Phone
(415) 346-8373
Fax
(411) 534-6080
NPI assigned
May 16, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2008

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

Authorized official

Name
Mr. Charles L Young
Title
Director
Phone
(415) 346-8373

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 0PT101670 CA Primary

Addresses

Primary practice location

1489 Webster St
Suite 210
San Francisco, CA 94115-3766

Mailing address

1489 Webster St
Suite 210
San Francisco, CA 94115-3766
Phone (415) 346-8373

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1210896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210896000000",
    "number": "1083871271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1489 WEBSTER ST",
            "address_2": "SUITE 210",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941153766",
            "telephone_number": "415-346-8373",
            "fax_number": "411-534-6080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1489 WEBSTER ST",
            "address_2": "SUITE 210",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941153766",
            "telephone_number": "415-346-8373",
            "fax_number": "411-534-6080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JULIE WONG'S PROACTIVE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-16",
        "last_updated": "2008-05-16",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "415-346-8373",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "0PT101670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 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.