Individual provider Active NPI

I Lane Wong, M.D.

  • Specialist
  • Irvine, CA
National Provider Identifier
1104036599
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G59317 Issued in CA
Practice address
2500 Alton Pkwy
Ste. 201
Irvine, CA 92606-5024
Phone
(949) 387-3888
Fax
(949) 387-3907
NPI assigned
May 23, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G59317 CA Primary

Addresses

Primary practice location

2500 Alton Pkwy
Ste. 201
Irvine, CA 92606-5024

Mailing address

2500 Alton Pkwy
Ste. 201
Irvine, CA 92606-5024
Phone (949) 387-3888

Other identifiers 3

IdentifierTypeStateIssuer
G59317OtherCAMEDICAL LICENSE NUMBER
INF1012OtherCAMONARCH HEALTHCARE ID
00G9317OtherCABLUE SHIELD ID

Other names 1

  • Irwin Lane Wong Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G59317CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
I. Lane Wong, M.D. Inc. Past Accepting new patients
Hope Ivf, Inc. Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104036599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 ALTON PKWY",
            "address_2": "STE. 201",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926065024",
            "telephone_number": "949-387-3888",
            "fax_number": "949-387-3907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 ALTON PKWY",
            "address_2": "STE. 201",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926065024",
            "telephone_number": "949-387-3888",
            "fax_number": "949-387-3907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "I",
        "middle_name": "LANE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G59317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE NUMBER",
            "identifier": "G59317",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MONARCH HEALTHCARE ID",
            "identifier": "INF1012",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD ID",
            "identifier": "00G9317",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IRWIN",
            "last_name": "WONG",
            "middle_name": "LANE",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.