Kenneth Kan Tin Wong, MD

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

A70448 Issued in CA

Practice address

1441 Eastlake Ave
Los Angeles, CA 90089-0112

Phone

(323) 865-3050

NPI assigned

Jun 13, 2005

Last updated

Mar 8, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Children's Hospital Los Angeles Medical Group, Inc.

  • Multi-Specialty Clinic/Center
  • Los Angeles, CA
  • NPI 1265530653
  Medicare reassignment NPD
• Usc Care Medical Group, Inc

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1902846306
  Medicare reassignment NPD
• Usc Care Medical Group, Inc

  dba Fair Oaks Clinic

  • Durable Medical Equipment & Medical Supplies
  • Pasadena, CA
  • NPI 1427937390
  NPD
• Cancer Care Consultants Medical Associates

  • Radiation Oncology Physician
  • Santa Monica, CA
  • NPI 1437271798
  NPD (past)
• Children's Hospital Los Angeles

  • Children's Chronic Disease Hospital
  • Los Angeles, CA
  • NPI 1366527954
  NPD (past)
• Childrens Hospital of Los Angeles

  • Children's Hospital
  • Los Angeles, CA
  • NPI 1124073366
  NPD (past)
• Genesiscare USA of California a Medical Corporation

  dba GenesisCare of California A Medical Corporation

  • Radiation Oncology Physician
  • Palm Desert, CA
  • NPI 1861472318
  NPD (past)
• Genesiscare USA of California a Medical Corporation

  dba GenesisCare of California A Medical Corporation

  • Radiation Oncology Physician
  • Modesto, CA
  • NPI 1881624583
  NPD (past)
• Keck Medical Center of Usc

  dba USC Kenneth Norris Jr. Hospital

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1417554528
  NPD (past)
• The Regents of the University of California

  dba Santa Monica UCLAMC and Orthopedic Hospital

  • General Acute Care Hospital
  • Santa Monica, CA
  • NPI 1982849105
  NPD (past)
• Usc University Hospital, Inc.

  dba USC Hospital

  • Psychiatric Hospital Unit
  • Los Angeles, CA
  • NPI 1790718500
  NPD (past)
• Usc Verdugo Hills Hospital, LLC

  dba Verdugo Hills Hospital

  • General Acute Care Hospital
  • Glendale, CA
  • NPI 1265875207
  NPD (past)

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457395200000",
    "number": "1184628695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "323-865-3050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 EASTLAKE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900890112",
            "telephone_number": "323-865-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "KENNETH",
        "middle_name": "KAN TIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2016-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CA",
            "license": "A70448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karyn A Wong, PT
• Katherine Suzanne Wong, M.D.
• Kelsey Wong, PHARMD
• Kelvin Wong
• Kenneth Wong, PHARM D
• Kenneth L Wong, PHARM.D.
• Kenny Wong, MS
• Kiana Marie Wong, OTR/L
• Kin Wong, MD
• King Heng Wong

• Radiation Oncology Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Radiation Oncology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2016; 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.