Bert KW Wong MD LLC

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

3694 Issued in HI

Legal business name

BERT KW WONG MD LLC

Practice address

2228 Liliha St
Suite 305
Honolulu, HI 96817-1646

Phone

(808) 526-0686

Fax

(808) 526-0688

NPI assigned

Apr 16, 2007

Organization subpart

No

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

Authorized official

Name

Bert KW Wong, MD

Title

Owner

Phone

(808) 526-0686

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273017600000",
    "number": "1235354887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2228 LILIHA ST",
            "address_2": "SUITE 305",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968171646",
            "telephone_number": "808-526-0686",
            "fax_number": "808-526-0688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2228 LILIHA ST",
            "address_2": "SUITE 305",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968171646",
            "telephone_number": "808-526-0686",
            "fax_number": "808-526-0688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERT KW WONG MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2010-05-05",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "BERT",
        "authorized_official_middle_name": "KW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "808-526-0686",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "HI",
            "license": "3694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "C17149",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03062302",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Berridge, M.S., SLP-CCC
• Lindsey Mura Kauikeolani Berrington, FNP
• Jakeyah Berry
• Kaori Mita Berry, L.AC
• Manon Lea Bersier, DDS
• Bert M. Sumikawa, D.D.S., Inc.
• John Thomas Berthiaume, M.D.
• Marcus Magallanes Bertolero, DC
• Grace Catherine Bertoli
• Patrick Bertulfo, FNP-BC

• Cardiovascular Disease Physician in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Cardiovascular Disease Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2010; 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.