Simon Wong

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

52029 Issued in CA

Practice address

2444 W Beverly Blvd
Montebello, CA 90640-2306

Phone

(323) 201-4130

Fax

(323) 201-4134

NPI assigned

Nov 14, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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

Interoperability endpoints

• Direct secure messaging: simon.wong.1@32527.direct.athenahealth.com

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.

• Albion Medical Partners of California West P C

  • Internal Medicine Physician
  • Cerritos, CA
  • NPI 1073110607
  Medicare reassignment

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

{
    "created_epoch": "1415923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1669878906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2444 W BEVERLY BLVD",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906402306",
            "telephone_number": "626-759-7175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2444 W BEVERLY BLVD",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906402306",
            "telephone_number": "323-201-4130",
            "fax_number": "323-201-4134"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "303 S Union Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900171111",
            "country_code": "US",
            "telephone_number": "213-355-2600",
            "fax_number": "213-355-2788",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WONG",
        "first_name": "SIMON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-14",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "52029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William R Hyman Dental Practice, Inc.
• Hiram J. Williams III, M.D.
• Keith Wilson
• Marie-Christine Wiltord, LMFT
• Carolyn Lee Wong, MS, LMFT
• Sylvia Wong, OTR/L
• Christina Woodson
• Charles B. Worley, PA-C
• Ruth S Wu, D.D.S.
• Wuu Shyong Wu M.D.

• Physician Assistant in Montebello, CA
• Providers in Montebello, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2024; 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.