Ida C Wong-Sefidan, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A108162 Issued in CA

Practice address

402 Dickinson St
MPF 3-320
San Diego, CA 92103-6902

Phone

(619) 543-1849

NPI assigned

Jun 25, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Ida C Wong Former name

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

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275868800000",
    "number": "1285830430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4661 GESNER PL",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921176743",
            "telephone_number": "917-232-4021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 DICKINSON ST",
            "address_2": "MPF 3-320",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921036902",
            "telephone_number": "619-543-1849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG-SEFIDAN",
        "first_name": "IDA",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-25",
        "last_updated": "2010-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A108162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IDA",
            "last_name": "WONG",
            "middle_name": "C",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Womens Health Care Inc
• Brittany Won
• Eric H Won, MD
• Kimberly Won
• Deanna M Wong Wan, OD
• Amor Escobedo Wong
• Amy Wong
• Ana Karen Wong
• Arlene Susan Wong, M.D.
• Arthur Daniel Wai-Yen Wong, MD

• Internal Medicine Physician in San Diego, CA
• Providers in San Diego, 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 Jun 7, 2010; 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.