Calvin K. Wong, MD, PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G79819 Issued in CA

Legal business name

CALVIN K. WONG, MD, PC

Practice address

5471 Kearny Villa Rd
Suite 200
San Diego, CA 92123-1143

Phone

(858) 571-0606

Fax

(858) 571-1933

NPI assigned

Apr 18, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Calvin K. Wong, MDNPI 1962400531

Title

President

Phone

(858) 571-0606

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 2

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

• Calvin K Wong, M.D.

  • Sports Medicine (Family Medicine) Physician
  • San Diego, CA
  • NPI 1962400531
  Medicare reassignment NPD Authorized official
• Ashley Joy Morrison, PA-C

  • Physician Assistant
  • San Diego, CA
  • NPI 1396459301
  Medicare reassignment

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271635200000",
    "number": "1679790232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5471 KEARNY VILLA RD",
            "address_2": "SUITE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231143",
            "telephone_number": "858-571-0606",
            "fax_number": "858-571-1933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5471 KEARNY VILLA RD",
            "address_2": "SUITE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231143",
            "telephone_number": "858-571-0606",
            "fax_number": "858-571-1933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALVIN K. WONG, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2010-04-19",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "CALVIN",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-571-0606",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G79819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "G79819",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER ID",
            "identifier": "WG79819C",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "G79819",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dan L Calvert
• Matias Calvillo Kemp
• Elijah Tomas Calvillo
• Luz Esperanza Calvillo
• Samantha Calvillo
• Kevin E Calvo, CPO FAAOP
• Kassandra Cam
• Cecilia Anneth Camacho Diaz
• Aries Camacho Limon
• Leslie Joanna Camacho Maciel, R1480640922

• Family Medicine Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2010; 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.