David T Wong, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

00G806640 Issued in CA

Practice address

400 N Pepper Ave
Armc - Mob Suite 308
Colton, CA 92324

Phone

(909) 580-6210

Fax

(909) 580-1363

NPI assigned

Aug 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General SurgeryAlso: Critical Care (Intensivists)

Education

Loma Linda University School of Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Paul J Wisniewski DO IncGroup PAC ID 5092240606, 19 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence St Mary Medical Center Hospital, Apple Valley, CA, CCN 050300

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Paul J Wisniewski DO Inc

  • Trauma Surgery Physician
  • Apple Valley, CA
  • NPI 1780433698
  Medicare reassignment Care Compare group NPD
• Cal Med Physicians and Surgeons, Inc.

  • Surgery Physician
  • Colton, CA
  • NPI 1316054737
  Medicare reassignment NPD
• Loma Linda University Medical Center

  • General Acute Care Hospital
  • Loma Linda, CA
  • NPI 1194731935
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St. Mary Medical Center

  dba Providence St. Mary Medical Center

  • Advanced Practice Midwife
  • Apple Valley, CA
  • NPI 1043406440

  Hospital

  Care Compare affiliation
• St. Mary Medical Center

  dba Providence St. Mary Medical Center

  • General Acute Care Hospital
  • Apple Valley, CA
  • NPI 1669456299
  Care Compare affiliation
• St. Mary Medical Center

  dba Providence St. Mary Medical Center

  • General Acute Care Hospital
  • Apple Valley, CA
  • NPI 1710109186
  Care Compare affiliation

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757376000000",
    "number": "1841307535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18523 CORWIN RD",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072338",
            "telephone_number": "909-712-2764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE",
            "address_2": "ARMC - MOB SUITE 308",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "92324",
            "telephone_number": "909-580-6210",
            "fax_number": "909-580-1363"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18523 Corwin Rd",
            "address_purpose": "LOCATION",
            "city": "Apple Valley",
            "state": "CA",
            "postal_code": "923072338",
            "country_code": "US",
            "telephone_number": "909-712-2764",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WONG",
        "first_name": "DAVID",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "CA",
            "license": "00G806640",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "CA",
            "license": "00G806640",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "00G806640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0079700",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clarence Carl Wilson, DBH, LPCC
• Jeffrey Randall Wirth, MFT
• Allison Lynn Wisniewski, D.O
• Kayla Marie Witcik, PA-C
• Alston Yip Wong
• Jane Wong
• Jane P Wong, PA-C
• Kelly Wong, PHARM D
• Patricia Wong, M.D.
• Shirley Patricia Wong, DO

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.