Individual provider Active NPI

Yiu Sing Eugene Wong, PA-C

  • Physician Assistant
  • San Francisco, CA
National Provider Identifier
1912535451
Registry record updated Nov 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
58719 Issued in CA
Practice address
199 W Portal Ave
San Francisco, CA 94127-1305
Phone
(415) 821-8798
Fax
(415) 242-6244
NPI assigned
Mar 30, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 58719 CA Primary

Addresses

Primary practice location

199 W Portal Ave
San Francisco, CA 94127-1305

Mailing address

3400 Data Dr
Rancho Cordova, CA 95670-7956

Other practice location 1

36 1st Ave
Boston, MA 02129-4557
Phone (617) 726-2947

Other names 1

  • Eugene Wong Other name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211028001978 CA Practitioner - Physician Assistant 3375950645 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Exer Medical CorporationGroup PAC ID 9032359534, 336 clinicians

Practice addresses (Care Compare)

11560 W Pico Blvd
Los Angeles, CA 90064-1520
Phone (310) 477-8285

2090 Westwood Blvd
Los Angeles, CA 90025-6329
Phone (213) 814-4070

2300 Wilshire Blvd
Suite 104
Santa Monica, CA 90403-5863
Phone (424) 416-7900

26777 Agoura Rd
Suite B4
Calabasas, CA 91302-2967
Phone (818) 880-2225

28900 S Western Ave
Rancho Palos Verdes, CA 90275-0805
Phone (424) 702-0500

5101 Lakewood Blvd
Lakewood, CA 90712-2413
Phone (562) 800-3883

8985 Venice Blvd
Suite a 3B
Los Angeles, CA 90034-3344
Phone (424) 502-1020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
58719CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Nes Western Group, a Professional Corporation CurrentSince Dec 6, 2022 Accepting new patients
Carbon Health Medical Group of California PC CurrentSince Feb 16, 2023 Accepting new patients
California Pacific Medical Group, Inc. Past Accepting new patients
Brigham and Womens Physicians Organization Inc Past Accepting new patients
Professional Portable Radiologic Services Inc. Past Accepting new patients

Locations

3195 Harbor Blvd
Ste 3
Costa Mesa, CA 92626
Phone (714) 263-0227

10165 Valley View St
Cypress, CA 90630
Phone (657) 348-2427

14443 Culver Dr
#14443A
Irvine, CA 92604
Phone (949) 767-8173

1040 W Imperial Hwy
Ste D
La Habra, CA 90631
Phone (714) 451-1072

3851 Katella Ave
Ste 100
Los Alamitos, CA 90720
Phone (562) 424-5450

858 N Rose Dr
Ste C2
Placentia, CA 92870
Phone (714) 792-3736

465 W Putnam Ave
Porterville, CA 93257
Phone (559) 784-8886

1998 Market St
San Francisco, CA 94102
Phone (415) 651-3558

2944 Tapo Canyon Rd
Ste A
Simi Valley, CA 93063
Phone (805) 306-5990

Interoperability endpoints

  • Direct secure messaging: eugene.wong.1@13869.direct.athenahealth.com

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1585526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1912535451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 W PORTAL AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941271305",
            "telephone_number": "415-821-8798",
            "fax_number": "415-242-6244"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "36 1st Ave",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021294557",
            "country_code": "US",
            "telephone_number": "617-726-2947",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WONG",
        "first_name": "YIU SING EUGENE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-30",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "58719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EUGENE",
            "last_name": "WONG",
            "credential": "PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.