Active NPI
Li Chiung Wong, MD
- Pediatrics Physician
- West Covina, CA
National Provider Identifier
1841392032
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- A60736
- Practice address
- 420 S Glendora Ave
West Covina, CA 91790-3001 - Phone
- (626) 919-5724
- NPI assigned
- Sep 1, 2006
- Last updated
- Jul 8, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | A60736 | CA | Primary |
Addresses
Primary practice location
420 S Glendora Ave
West Covina, CA 91790-3001
Mailing address
2300 Greenfield Ave
Arcadia, CA 91006-5225
Phone (626) 254-0854
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A607360 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A60736 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| La Verne Family Medical Center Inc | Past | Accepting new patients | |
| Pomona Valley Hospital Medical Center | Past | Accepting new patients | |
| Emanate Health Medical Center | Past | Accepting new patients |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- li.wong.p1@direct.evchc.nextgenshare.com
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.
-
dba Citrus Valley Medical Center Inter-Community Campus
- General Acute Care Hospital
- Covina, CA
- NPI 1982629440
-
- Family Medicine Physician
- La Verne, CA
- NPI 1457469884
-
- General Acute Care Hospital
- Pomona, CA
- NPI 1518067586
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1841392032",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2300 GREENFIELD AVE",
"city": "ARCADIA",
"state": "CA",
"postal_code": "910065225",
"telephone_number": "626-254-0854"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 S GLENDORA AVE",
"city": "WEST COVINA",
"state": "CA",
"postal_code": "917903001",
"telephone_number": "626-919-5724"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "LI",
"middle_name": "CHIUNG",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A60736",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A607360",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in West Covina, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.