Johnson Kar Tsun Wong, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G79608 Issued in CA

Practice address

14568A Mono Way
Sonora, CA 95370-8858

Phone

(209) 768-1217

Fax

(209) 533-2061

NPI assigned

Sep 23, 2005

Reactivated

Oct 1, 2008

Sex

Male

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222819200000",
    "number": "1184875759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14568A MONO WAY",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953708858",
            "telephone_number": "209-768-1217",
            "fax_number": "209-533-2061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14568A MONO WAY",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953708858",
            "telephone_number": "209-768-1217",
            "fax_number": "209-533-2061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "replacement_npi": "1184875759",
        "last_name": "WONG",
        "first_name": "JOHNSON",
        "middle_name": "KAR TSUN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-23",
        "last_updated": "2008-10-01",
        "deactivation_date": "2008-08-21",
        "reactivation_date": "2008-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G79608",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER TAX ID#",
            "identifier": "72-1325399",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP ID#",
            "identifier": "ZZZ04982Z",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G796080",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Linda J. Wobeskya, PT
• Andreas Wolf, MD
• Krysta Lee Wolken, NP-C
• Wong Center Inc
• Deborah F Wong, MD
• Karen Elizabeth Wood, LMFT
• Mathew Thomas Wood
• David E. Woodhams, D.D.S.
• Woods Creek Psychological Group, Apc
• Charles Wright, M.D.

• Internal Medicine Physician in Sonora, CA
• Providers in Sonora, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2008; 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.