Active NPI
Patricia Lynn Wong, MD
- Dermatology Physician
- Palo Alto, CA
National Provider Identifier
1629138847
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- G543820
- Practice address
- 735 Cowper Street
Palo Alto, CA 94301 - Phone
- (650) 473-3173
- Fax
- (650) 473-2312
- NPI assigned
- Dec 11, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | G543820 | CA | |
| Dermatology Physician | 207N00000X | G543820 | CA | Primary |
Addresses
Primary practice location
735 Cowper Street
Palo Alto, CA 94301
Mailing address
735 Cowper Street
Palo Alto, CA 94301
Phone (650) 473-3173
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Sep 16, 2025 through Sep 16, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G543820 | CA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Csi Medical Group | Dermatology | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1745971200000",
"number": "1629138847",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "735 COWPER STREET",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "94301",
"telephone_number": "650-473-3173",
"fax_number": "650-473-2312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "735 COWPER STREET",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "94301",
"telephone_number": "650-473-3173",
"fax_number": "650-473-2312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "PATRICIA",
"middle_name": "LYNN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-11",
"last_updated": "2025-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "G543820",
"primary": false
},
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "CA",
"license": "G543820",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palo Alto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.