Individual provider Active NPI

Gregory Henry Wong, D.C.

  • Chiropractor
  • Los Alamitos, CA
National Provider Identifier
1417029570
Registry record updated Dec 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
21568 Issued in CA
Practice address
5122 Katella Ave
Suite 300
Los Alamitos, CA 90720-2826
Phone
(562) 596-4800
Fax
(562) 596-4855
NPI assigned
Nov 14, 2006
Last updated
Dec 19, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 21568 CA Primary

Addresses

Primary practice location

5122 Katella Ave
Suite 300
Los Alamitos, CA 90720-2826

Mailing address

5122 Katella Ave
Suite 300
Los Alamitos, CA 90720-2826
Phone (562) 596-4800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240709003262 CA Practitioner - Chiropractic 1951846492 Practice locations: Los Alamitos, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21568CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Paul W. Gee, D.C., Inc Chiropractor Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198022400000",
    "number": "1417029570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5122 KATELLA AVE",
            "address_2": "SUITE 300",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907202826",
            "telephone_number": "562-596-4800",
            "fax_number": "562-596-4855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5122 KATELLA AVE",
            "address_2": "SUITE 300",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907202826",
            "telephone_number": "562-596-4800",
            "fax_number": "562-596-4855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "GREGORY",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2007-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "21568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Alamitos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.