Kong D Wong MD Inc

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

A31644 Issued in CA

Legal business name

KONG D WONG MD INC

Practice address

15203 11TH St
Suite B
Victorville, CA 92395-3737

Phone

(760) 245-6691

Fax

(760) 245-2671

NPI assigned

Oct 8, 2012

Last updated

Oct 8, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

William K Wong, M.D.NPI 1316014392

Title

President

Phone

(760) 245-6691

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• William K Wong, MD

  • Cardiovascular Disease Physician
  • Victoville, CA
  • NPI 1316014392
  NPD Authorized official

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

{
    "created_epoch": "1349654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349654400000",
    "number": "1740532282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15203 11TH ST",
            "address_2": "SUITE B",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923953737",
            "telephone_number": "760-245-6691",
            "fax_number": "760-245-2671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15203 11TH ST",
            "address_2": "SUITE B",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923953737",
            "telephone_number": "760-245-6691",
            "fax_number": "760-245-2671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KONG D WONG MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-08",
        "last_updated": "2012-10-08",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-245-6691",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "A31644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Knolls West Enterprises
• Knolls West Post Acute LLC
• Linna C Ko, PHARM D
• Samuel H Ko, D.D.S.
• Stephen Kolakowski Jr., MD
• Jennifer Konior, PA-C
• Alan Jay Koo
• Sandra Kopp, RN
• Edward Leonard Korthuis, D.C.
• Hiren Ramanikbhai Koshiya

• Primary Care Clinic/Center in Victorville, CA
• Providers in Victorville, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2012; 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.