Kelly Wong DO Inc

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

20A10595 Issued in CA

Legal business name

KELLY WONG DO INC

Practice address

500 N Garfield Ave Ste 105
Monterey Park, CA 91754-1242

Phone

(626) 288-3828

Fax

(626) 573-8513

NPI assigned

Jul 16, 2010

Organization subpart

No

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

Authorized official

Name

Kelly Wong, DONPI 1215106448

Title

President

Phone

(626) 288-3828

Specialties & licenses 1

Addresses

Other names 1

• KELLY WONG D O INC Other name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 6

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

• Kelly Tim Tim Wong, D.O.

  • Family Medicine Physician
  • Monterey Park, CA
  • NPI 1215106448
  Medicare reassignment NPD Authorized official
• David M Fang, M.D.

  • General Acute Care Hospital
  • Bakersfield, CA
  • NPI 1063697233
  NPD
• Tin Wong, DO

  • Adult Medicine Physician
  • Los Angeles, CA
  • NPI 1588927552
  NPD
• Eric Cheng Kun Chang, MD

  • Medical Oncology Physician
  • Monterey Park, CA
  • NPI 1427123488
  NPD (past)
• Jennifer Chen, MD

  • Internal Medicine Physician
  • San Gabriel, CA
  • NPI 1548335516
  NPD (past)
• Kai Y Wong, M.D.

  • Family Medicine Physician
  • Arcadia, CA
  • NPI 1376656967
  NPD (past)

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

{
    "created_epoch": "1279238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646006400000",
    "number": "1427361617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N GARFIELD AVE STE 105",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917541242",
            "telephone_number": "626-288-3828",
            "fax_number": "626-573-8513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N GARFIELD AVE STE 105",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917541242",
            "telephone_number": "626-288-3828",
            "fax_number": "626-573-8513"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "711 W College St Ste 208",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900121093",
            "country_code": "US",
            "telephone_number": "626-826-4899",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KELLY WONG DO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-16",
        "last_updated": "2022-02-28",
        "certification_date": "2022-02-28",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-288-3828",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "20A10595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KELLY WONG D O INC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Irvin Kaw, DMD
• Phillip Z Kaw
• Kaygo Consultants
• KC Tan, M.D. Medical Corporation
• Antranig Gary Kelleyan, D.D.S.
• Kelvin H Nguyen Foot & Ankle Corporation
• Shiun T Ker, M.D.
• Kevin H. Tseng, D.P.M.
• Kevin Trong Nguyen DO Inc
• Khiem PV Nguyen MD Cardiology Associates Medical Group Inc

• Primary Care Clinic/Center in Monterey Park, CA
• Providers in Monterey Park, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2022; 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.