Susie Yin-Peng Wong, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

C042888 Issued in CA

Practice address

18617 Gale Ave
City of Industry, CA 91748-1342

Phone

(626) 912-1871

Fax

(626) 912-6766

NPI assigned

Jul 4, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334707200000",
    "number": "1144250994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18617 GALE AVE",
            "city": "CITY OF INDUSTRY",
            "state": "CA",
            "postal_code": "917481342",
            "telephone_number": "626-912-1871",
            "fax_number": "626-912-6766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18617 GALE AVE",
            "city": "CITY OF INDUSTRY",
            "state": "CA",
            "postal_code": "917481342",
            "telephone_number": "626-912-1871",
            "fax_number": "626-912-6766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "SUSIE",
        "middle_name": "YIN-PENG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2012-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "C042888",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C428880",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Bao, MD Inc
• Adriana Williams
• Asia Wilson
• Avay Witherspoon
• Chan Kiet Wong, PHARM. D.
• Theodora Wong, MD, RD
• Bonnie B Woo, M.D.
• Kanyang Wu, PHD, L.AC.
• Tong Wu
• Weizhi Wu

• Ophthalmology Physician in City of Industry, CA
• Providers in City of Industry, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.