Kelly Kwok Wong, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A65226 Issued in CA

Practice address

728 Pacific Ave # 703
San Francisco, CA 94133-4457

Phone

(415) 805-7782

Fax

(415) 805-7783

NPI assigned

Oct 12, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• California Pacific Medical Group, Inc.

  • Multi-Specialty Clinic/Center
  • Oakland, CA
  • NPI 1275002453
  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655856000000",
    "number": "1699865741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "728 PACIFIC AVE # 703",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941334457",
            "telephone_number": "415-805-7782",
            "fax_number": "415-805-7783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "728 PACIFIC AVE # 703",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941334457",
            "telephone_number": "415-805-7782",
            "fax_number": "415-805-7783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "KELLY",
        "middle_name": "KWOK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A65226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kellykwong@hotmail.com",
            "affiliation": "N",
            "endpointDescription": "Chinatown/Stonestown email direct",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "728 Pacific Ave Ste 703",
            "city": "San Francisco",
            "state": "CA",
            "country_code": "US",
            "postal_code": "941334492",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Karina Wong, PSY.D.
• Karissa Wong
• Kathleen Wong, PHARM.D.
• Kathy Ka Yee Wong, DDS
• Keith Wong, ASW
• Kenley Wong, DPM
• Kenneth Wong
• Kenneth Loren Wong, D.D.S.
• Kevin Wong
• Keziah James Wong

• Pediatrics Physician in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.