Jack K Wong, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

C50860 Issued in CA

Practice address

3200 Bristol St Ste 600
Costa Mesa, CA 92626-1810

Phone

(805) 217-7904

NPI assigned

Jun 8, 2006

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jack.wong.1@8236.direct.athenahealth.com
• Direct secure messaging: jack.wong@3856.securemail.prognocis.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.

• Last Frontier Healthcare District

  • Critical Access Hospital
  • Alturas, CA
  • NPI 1487669032
  NPD (past)
• Jefferson County Healthcare Authority

  • Critical Access Hospital
  • Waurika, OK
  • NPI 1144245655

  Family Medicine

  NPD (past)
• Winslow Indian Health Care Center, Inc

  • Federal Public Health Clinic/Center
  • Leupp, AZ
  • NPI 1760652580
  NPD (past)

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763510400000",
    "number": "1790725539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 BRISTOL ST STE 600",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926261810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 BRISTOL ST STE 600",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926261810",
            "telephone_number": "805-217-7904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "JACK",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C50860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maxine King Wofford, LVN
• Amie Lynn Wolbrecht, SP
• Eric Wolf
• Alethea Wong
• Candice Wong
• Jane Wong
• Johnny Chunkau Wong
• Lai Man Wong
• Miki Michelle Wong
• Stacey Wong, DPT

• Family Medicine Physician in Costa Mesa, CA
• Providers in Costa Mesa, 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 Nov 19, 2025; 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.