Active NPI
Khin Wong, MD
- Infectious Disease Physician
- Riverside, CA
National Provider Identifier
1225105042
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Infectious Disease Physician
- License
- A45193
- Practice address
- 10800 Magnolia Ave
Riverside, CA 92505-3043 - Phone
- (909) 353-2000
- NPI assigned
- Nov 29, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Infectious Disease Physician | 207RI0200X | A45193 | CA | Primary |
Addresses
Primary practice location
10800 Magnolia Ave
Riverside, CA 92505-3043
Mailing address
10800 Magnolia Ave
Riverside, CA 92505-3043
Phone (909) 353-3030
Other names 1
- Dr. Edna Y Wong
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 45193 | CA | MD | General Practice Dentistry |
| A45193 | CA | MD | Infectious Disease Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1253145600000",
"number": "1225105042",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10800 MAGNOLIA AVE",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925053043",
"telephone_number": "909-353-3030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10800 MAGNOLIA AVE",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925053043",
"telephone_number": "909-353-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "KHIN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-29",
"last_updated": "2009-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "207RI0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Infectious Disease",
"state": "CA",
"license": "A45193",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "EDNA",
"last_name": "WONG",
"middle_name": "Y",
"prefix": "DR.",
"credential": "M.D.",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.