Individual provider Active NPI

Hubert E Wong, MD

  • Emergency Medicine Physician
  • San Clemente, CA
National Provider Identifier
1356365290
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A73672 Issued in CA
Practice address
654 Camino de Los Mares
San Clemente, CA 92673-2827
Phone
(330) 493-4443
Fax
(330) 493-8677
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A73672 CA Primary

Addresses

Primary practice location

654 Camino de Los Mares
San Clemente, CA 92673-2827

Mailing address

4535 Dressler Rd NW
Canton, OH 44718-2545
Phone (330) 493-4443

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20060227000159 CA Practitioner - Emergency Medicine 0749296986 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
73672CAMDMarriage & Family Therapist
A73672CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Emergency Medicine Current Accepting new patients
Cep America-California Emergency Medicine CurrentSince Jan 1, 2006 Accepting new patients
Cep America-California Emergency Medicine CurrentSince Jan 1, 2006 Accepting new patients

Locations

751 Medical Center Ct
#1182
Chula Vista, CA 91911

9920 Talbert Ave
Fountain Vly, CA 92708
Phone (714) 236-4000

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

654 Camino de los Mares
San Clemente, CA 92673
Phone (949) 489-4507

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356365290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4535 DRESSLER RD NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182545",
            "telephone_number": "330-493-4443",
            "fax_number": "330-493-8677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "654 CAMINO DE LOS MARES",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926732827",
            "telephone_number": "330-493-4443",
            "fax_number": "330-493-8677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "HUBERT",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A73672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Clemente, CA

Sources for this page

Verify at the official NPI Registry.