William K Wong, MD
Individual provider Active NPI Cardiovascular Disease Physician · Victoville, CA
NPI 1316014392 · NPPES record last updated Dec 27, 2011
Key facts
- NPI
- 1316014392
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Cardiovascular Disease Physician 207RC0000X
- License
- A31644 (CA)
- Practice address
- 15203 11TH Street
Suite B
Victoville, CA 92395-3737 - Phone
- (760) 245-6691
- Fax
- (760) 245-2671
- NPI assigned
- Nov 29, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A31644 | CA | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vvipa Medical Group Inc | Current | Accepting new patients | |
| Kong D Wong MD Inc | Current |
Accepting new patients | |
| High Desert Medical Group | Current |
Accepting new patients | |
| Kenneth V. Miselis, M.D. Inc. | Past | Accepting new patients |
Locations
12370 Hesperia Rd
Ste 9
Victorville, CA 92395
Phone (760) 261-5227
15203 Eleventh St
Ste B
Victorville, CA 92395
Phone (760) 245-6691
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | A31644 | CA | Yes |
Addresses
Primary practice location
15203 11TH Street
Suite B
Victoville, CA 92395-3737
Mailing address
15203 11TH Street
Suite B
Victoville, CA 92395-3737
Phone (760) 245-6691
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A316440 | Medicaid | CA |
Other names
- Dr. Kong D Wong
Other providers in Victoville, CA
All providers in Victoville, CA · Cardiovascular Disease Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 27, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.