Jeffrey C.M. Wong, D.O.
Individual provider Active NPI Obstetrics & Gynecology Physician · Waimea, HI
NPI 1508933763 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1508933763
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- DOS-683 (HI)
- Practice address
- 4643B Waimea Canyon Dr.
Waimea, HI 96796 - Phone
- (808) 338-8311
- Fax
- (808) 338-0225
- NPI assigned
- Nov 30, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DOS-683 | HI | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Daniel J Cain DO Inc | Obstetrics & Gynecology | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | DOS-683 | HI | Yes |
Addresses
Primary practice location
4643B Waimea Canyon Dr.
Waimea, HI 96796
Mailing address
4643B Waimea Canyon Dr
Waimea, HI 96796
Phone (808) 338-8311
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 24873101 | Medicaid | HI | |
| DOS683-01 | Other | MDX | |
| 49971600 | Other | QUEST ALOHACARE | |
| 7100402 | Other | UHA | |
| 518708 | Other | HMA | |
| G40180 | Other | KAISER |
Other providers in Waimea, HI
- Beverly Esplana Tumbaga
- Waimea Emergency Services LLC
- West Hawaii Imaging Services, Inc
- Narreinar Pawsheun Williams
- Elliot R Willis-Orlando
All providers in Waimea, HI · Obstetrics & Gynecology Physician in Hawaii
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.