NPIMap

Individual provider Active NPI

Jair Wong, MD

  • Internal Medicine Physician
  • West Covina, CA
National Provider Identifier
1972541266
Registry record updated Oct 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G75543 Issued in CA
Practice address
906 S Sunset Ave Ste 102
West Covina, CA 91790-3400
Phone
(626) 962-9108
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G75543 CA Primary

Addresses

Primary practice location

906 S Sunset Ave Ste 102
West Covina, CA 91790-3400

Mailing address

906 S Sunset Ave Ste 102
West Covina, CA 91790-3400
Phone (626) 962-9108

Other practice location 1

1535 W. Merced Ave
Suite #102
West Covina, CA 91790
Phone (626) 962-9108

Other identifiers 1

IdentifierTypeStateIssuer
WG75543FMedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040826000487 CA Practitioner - Internal Medicine 2365416328 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Oklahoma College of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

906 S Sunset Ave
Suite 102
West Covina, CA 91790-3400
Phone (626) 962-9108

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G75543CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emanate Health Foothill Presbyterian Hospital Past Accepting new patients
Emanate Health Medical Center Past Accepting new patients
Emanate Health Medical Center Past Accepting new patients
San Dimas Community Hospital, Inc. Past Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 6

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 6

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538956800000",
    "number": "1972541266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "906 S SUNSET AVE STE 102",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903400",
            "telephone_number": "626-962-9108",
            "fax_number": "626-960-7337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 S SUNSET AVE STE 102",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903400",
            "telephone_number": "626-962-9108"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1535 W. Merced Ave",
            "address_2": "Suite #102",
            "address_purpose": "LOCATION",
            "city": "West Covina",
            "state": "CA",
            "postal_code": "91790",
            "country_code": "US",
            "telephone_number": "626-962-9108",
            "fax_number": "626-960-7337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WONG",
        "first_name": "JAIR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2018-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G75543",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "WG75543F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

Verify at the official NPI Registry.