Gregory San Wong, MD

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

A96833 Issued in CA

Practice address

1700 Cesar Chavez Ave
Senior Care Clinic
Los Angeles, CA 90033-2414

Phone

(323) 307-0800

Fax

(323) 307-0803

NPI assigned

Jan 24, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254355200000",
    "number": "1336294875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 CESAR CHAVEZ AVE #3900",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900332414",
            "telephone_number": "323-307-0800",
            "fax_number": "323-307-0803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 CESAR CHAVEZ AVE",
            "address_2": "SENIOR CARE CLINIC",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900332414",
            "telephone_number": "323-307-0800",
            "fax_number": "323-307-0803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "GREGORY",
        "middle_name": "SAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2009-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "A96833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A968330",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gigi Wong
• Gloria Lee Wong
• Grace Wong, DO
• Greg Wong
• Gregory Jamison Wong, MD
• Haley M Wong
• Han-CHI Helen Wong, MD
• Harry Jingze Wong, M.D.
• Irene Tang Wong, OD
• Janet Wong, M.S.W.

• Geriatric Medicine (Internal Medicine) Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Geriatric Medicine (Internal Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2009; 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.