Active NPI
Kathleen A Wong, M.D.
- Internal Medicine Physician
- San Diego, CA
National Provider Identifier
1831200278
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- A69612
- Practice address
- 2929 Health Center Dr
San Diego, CA 92123-2762 - Phone
- (858) 499-2777
- NPI assigned
- Aug 31, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | A69612 | CA | |
| Internal Medicine Physician | 207R00000X | A69612 | CA | Primary |
Addresses
Primary practice location
2929 Health Center Dr
San Diego, CA 92123-2762
Mailing address
2929 Health Center Dr
San Diego, CA 92123-2762
Phone (858) 499-2777
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A696120 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sharp Rees-Stealy Medical Group, Inc | Internal Medicine | Current | Accepting new patients |
| Sharp Rees-Stealy Medical Group, Inc | Current | Accepting new patients | |
| Heal Doctors Ihwa, P.C. | Internal Medicine | Past | Accepting new patients |
Locations
2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500
2929 Health Center Dr
San Diego, CA 92123
Phone (858) 939-6531
Organizations & group practices 3
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.
-
- Optometrist
- San Diego, CA
- NPI 1063172351
-
- Internal Medicine Physician
- San Diego, CA
- NPI 1285616177
-
- Internal Medicine Physician
- Baton Rouge, LA
- NPI 1447917125
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1575244800000",
"number": "1831200278",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2929 HEALTH CENTER DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921232762",
"telephone_number": "858-499-2777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2929 HEALTH CENTER DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921232762",
"telephone_number": "858-499-2777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "KATHLEEN",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-31",
"last_updated": "2019-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "CA",
"license": "A69612",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "A69612",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A696120",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.