Individual provider Active NPI

Norman C K Wong, MD

  • General Practice Physician
  • Rialto, CA
National Provider Identifier
1174626212
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A47829 Issued in CA
Practice address
195 E Foothill Blvd
Rialto, CA 92376
Phone
(909) 874-3490
Fax
(909) 874-3470
NPI assigned
Sep 6, 2006
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
General Practice Physician 208D00000X A47829 CA Primary

Addresses

Primary practice location

195 E Foothill Blvd
Rialto, CA 92376

Mailing address

13563 Via San Remo
Chino Hills, CA 91709
Phone (909) 465-9949

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
A47829CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Christine D Forest, M.D. Inc. Past Accepting new patients
Parviz Fahimian MD, 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174626212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13563 VIA SAN REMO",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "91709",
            "telephone_number": "909-465-9949",
            "fax_number": "909-591-6450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 E FOOTHILL BLVD",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "92376",
            "telephone_number": "909-874-3490",
            "fax_number": "909-874-3470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "NORMAN",
        "middle_name": "C K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A47829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rialto, 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.