Individual provider Active NPI

Christopher Che Dar Wong, DO

  • Nephrology Physician
  • San Dimas, CA
National Provider Identifier
1881985612
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
20A12470 Issued in CA
Practice address
1335 Cypress St Ste 205
San Dimas, CA 91773-3538
Phone
(909) 542-2777
NPI assigned
Apr 27, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 20A12470 CA Primary

Addresses

Primary practice location

1335 Cypress St Ste 205
San Dimas, CA 91773-3538

Mailing address

1335 Cypress St Ste 205
San Dimas, CA 91773-3538
Phone (909) 542-2777

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
I20160912000361 CA Practitioner - NephrologyPractitioner - Internal Medicine 3173819547 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
University of Southern California Keck School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
California Kidney SpecialistsGroup PAC ID 0345232096, 16 clinicians

Practice addresses (Care Compare)

1335 Cypress St
Suite 205
San Dimas, CA 91773-3538
Phone 90954227772770

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A12470CAMDNephrology Physician
12470CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
California Kidney Specialists Nephrology CurrentSince Jul 16, 2016 Accepting new patients
Casa Colina Hospital and Centers for Healthcare Current Accepting new patients
Southern California Hospitalist Network Medical Group Inc CurrentSince Sep 1, 2016 Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients
Usc Arcadia Hospital Past Accepting new patients
Emanate Health Medical Center Past Accepting new patients
Community Medical Center Inc Past Accepting new patients
Emanate Health Foothill Presbyterian Hospital Past Accepting new patients
Emanate Health Medical Center Past Accepting new patients
Physicians of Southern California Inc PastSince Mar 18, 2022 Accepting new patients

Locations

315 N 3rd Ave
Ste 104
Covina, CA 91723
Phone (626) 331-0133

717 W Foothill Blvd
Monrovia, CA 91016
Phone (626) 327-9805

1304 W Holt Blvd
Ste A
Ontario, CA 91762
Phone (626) 859-2249

1304 W Holt Blvd
#A
Ontario, CA 91762

625 The City Dr S
Ste 320
Orange, CA 92868
Phone (714) 202-2330

3235 E Colorado Blvd
Ste 102
Pasadena, CA 91107
Phone (626) 859-2249

6850 Brockton Ave
Ste 102
Riverside, CA 92506
Phone (626) 859-2249

9380 Magnolia Ave
Riverside, CA 92503
Phone (951) 373-5620

1350 W Covina Blvd
San Dimas, CA 91773
Phone (909) 394-2745

399 E Highland Ave
Ste 227
Sn Bernrdno, CA 92404
Phone (909) 381-1595

1500 N Waterman Ave
#B
Sn Bernrdno, CA 92404
Phone (909) 381-1595

901 San Bernardino Rd
Ste 104
Upland, CA 91786
Phone (909) 542-2779

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/5192cc27-2764-47df-a8de-8ad1cf29ade6/
  • Direct secure messaging: christopher.wong@californiakidney.cernerdirect.com
  • Direct secure messaging: casacolina@direct.casacolina.org

Organizations & group practices 10

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1303862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1881985612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1335 CYPRESS ST STE 205",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917733538",
            "telephone_number": "909-542-2777",
            "fax_number": "909-394-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1335 CYPRESS ST STE 205",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917733538",
            "telephone_number": "909-542-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "CHRISTOPHER",
        "middle_name": "CHE DAR",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-27",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "20A12470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Dimas, CA

Sources for this page

Verify at the official NPI Registry.