Charles D Wong DO Medical Corporation

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

20A8787 Issued in CA

Legal business name

CHARLES D WONG DO MEDICAL CORPORATION

Practice address

9500 Stockdale Hwy
Suite 109
Bakersfield, CA 93311-3620

Phone

(661) 663-6550

Fax

(661) 663-6259

NPI assigned

Sep 12, 2012

Organization subpart

No

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

Authorized official

Name

Charles D Wong, DONPI 1255508131

Title

President

Phone

(661) 324-0300

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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.

• Charles David Wong, D.O.

  • Orthopaedic Hand Surgery Physician
  • Bakersfield, CA
  • NPI 1255508131
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1347408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355875200000",
    "number": "1821348392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2287",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933032287",
            "telephone_number": "661-324-0300",
            "fax_number": "661-324-4095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 STOCKDALE HWY",
            "address_2": "SUITE 109",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933113620",
            "telephone_number": "661-663-6550",
            "fax_number": "661-663-6259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES D WONG DO MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-12",
        "last_updated": "2012-12-19",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "661-324-0300",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "CA",
            "license": "20A8787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Bakersfield, CA
• Providers in Bakersfield, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2012; 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.