Judy Ming Yu Wong

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

56270 Issued in CA

Practice address

611 Maple Ave
Los Angeles, CA 90014-2211

Phone

(714) 488-9129

NPI assigned

May 10, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Signify Health Medical Associates of California, PC

  • General Practice Physician
  • San Francisco, CA
  • NPI 1124685169
  Medicare reassignment NPD

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

{
    "created_epoch": "1557446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629244800000",
    "number": "1508422056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 86532",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900860532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 MAPLE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900142211",
            "telephone_number": "714-488-9129"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 S Flower St",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900152295",
            "country_code": "US",
            "telephone_number": "714-488-9129",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1113 S Main St Ste A",
            "address_purpose": "LOCATION",
            "city": "Corona",
            "state": "CA",
            "postal_code": "928824455",
            "country_code": "US",
            "telephone_number": "951-444-0467",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4075 Tweedy Blvd",
            "address_purpose": "LOCATION",
            "city": "South Gate",
            "state": "CA",
            "postal_code": "902806146",
            "country_code": "US",
            "telephone_number": "323-566-4111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WONG",
        "first_name": "JUDY",
        "middle_name": "MING YU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-10",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95010946",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "56270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joanna Wong, SLP
• John P Wong, M.D.
• Jonathan Sze Yin Wong, PSY.D
• Joseph Isaac Salientes Wong, MD
• Joshua W Wong, M.D.
• Karyan Kara Wong, OTR/L
• Karyn A Wong, PT
• Katherine Suzanne Wong, M.D.
• Kelsey Wong, PHARMD
• Kelvin Wong

• Physician Assistant in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2021; 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.