Individual provider Active NPI

Harry Kevin Wong, D.C.

  • Chiropractor
  • Belmont, CA
National Provider Identifier
1841352416
Registry record updated Nov 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC 14813 Issued in CA
Practice address
1021 Alameda de Las Pulgas
Belmont, CA 94002-3507
Phone
(650) 365-7775
Fax
(650) 365-7890
NPI assigned
Dec 13, 2006
Last updated
Nov 25, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC 14813 CA Primary

Addresses

Primary practice location

1021 Alameda de Las Pulgas
Belmont, CA 94002-3507

Mailing address

1021 Alameda de Las Pulgas
Belmont, CA 94002-3507
Phone (650) 365-7775

Other identifiers 1

IdentifierTypeStateIssuer
14813OtherCAD.C. LICENSE

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20081112000844 CA Practitioner - ChiropracticPractitioner - Diagnostic Radiology 1052482916

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC 14813CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Active Life Medical Center Chiropractor PastSince Jan 1, 2007 Accepting new patients
Activa Medical Center, Inc. PastSince Mar 19, 2008 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448409600000",
    "number": "1841352416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 ALAMEDA DE LAS PULGAS",
            "city": "BELMONT",
            "state": "CA",
            "postal_code": "940023507",
            "telephone_number": "650-365-7775",
            "fax_number": "650-365-7890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 ALAMEDA DE LAS PULGAS",
            "city": "BELMONT",
            "state": "CA",
            "postal_code": "940023507",
            "telephone_number": "650-365-7775",
            "fax_number": "650-365-7890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "HARRY",
        "middle_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2015-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC 14813",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "D.C. LICENSE",
            "identifier": "14813",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Belmont, CA

Sources for this page

Verify at the official NPI Registry.