Kalane Jade Wong, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

G62085 Issued in CA

Practice address

1017 2ND St
Santa Rosa, CA 95404-6608

Phone

(707) 546-9800

Fax

(707) 546-4112

NPI assigned

Jan 5, 2006

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: kwong209015@hisp.ehr.sutterhealth.org

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

{
    "created_epoch": "1136419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340150400000",
    "number": "1114905494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3536 MENDOCINO AVE",
            "address_2": "STE 200",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954033634",
            "telephone_number": "707-546-9800",
            "fax_number": "707-546-4112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 2ND ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954046608",
            "telephone_number": "707-546-9800",
            "fax_number": "707-546-4112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "KALANE",
        "middle_name": "JADE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-05",
        "last_updated": "2012-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G62085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01035552",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G620850",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Women'S Recovery Services, a Unique Place
• Womens OB/GYN Medical Group
• Amy Bee Wong, D.D.S.
• Jeanine Wong
• Julia May Wong, DO
• Kathy M Wong, PHARM.D.
• Laura Ann Wong, PHARM.D
• Melinda Joy Wong, FNP
• Raymond Sing Wong, PHARM.D
• Richard Gary Wong, DC

• Ophthalmology Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2012; 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.