Organization Active NPI

Ka Woo Medical Clinic Inc

  • Internal Medicine Physician
  • Alhambra, CA
National Provider Identifier
1407075948
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A53201 Issued in CA
Legal business name
KA WOO MEDICAL CLINIC INC
Practice address
841 W Valley Blvd Ste 107
Alhambra, CA 91803-3251
Phone
(626) 282-3657
Fax
(626) 282-2759
NPI assigned
Apr 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Tim Wong
Title
Office Manager
Phone
(626) 282-3657

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X A53201 CA Primary

Addresses

Primary practice location

841 W Valley Blvd Ste 107
Alhambra, CA 91803-3251

Mailing address

841 W Valley Blvd Ste 107
Alhambra, CA 91803-3251
Phone (626) 282-3657

Other identifiers 1

IdentifierTypeStateIssuer
00A532013MedicaidCA

Other names 1

  • Nora Tee Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101104001338 CA Part B Supplier - Clinic/Group Practice 7719171529 Receives reassigned benefits from 1 practitioner
Practice locations: Alhambra, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0903506Ka Woo Medical Clinic Inc841 W Valley Blvd Suite 107, Alhambra, CA 91803Certificate of waiverJul 23, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407075948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "841 W VALLEY BLVD STE 107",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918033251",
            "telephone_number": "626-282-3657",
            "fax_number": "626-282-2759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "841 W VALLEY BLVD STE 107",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918033251",
            "telephone_number": "626-282-3657",
            "fax_number": "626-282-2759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KA WOO MEDICAL CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "626-282-3657",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A53201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A532013",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nora Tee",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Alhambra, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.