Active NPI
Wade Wong, MD
- Neuroradiology Physician
- La Jolla, CA
National Provider Identifier
1972685949
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neuroradiology Physician
- License
- 20A3872
- Practice address
- 9300 Campus Point Dr
7756
La Jolla, CA 92037 - Phone
- (858) 657-6650
- NPI assigned
- Oct 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | 20A3872 | CA | |
| Neuroradiology Physician | 2085N0700X | 20A3872 | CA | Primary |
Addresses
Primary practice location
9300 Campus Point Dr
7756
La Jolla, CA 92037
Mailing address
9300 Campus Point Dr
Mail Code 7756
La Jolla, CA 92037
Phone (858) 657-6650
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00AX38720 | 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)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Regents of the University of California | Neuroradiology | Past | Accepting new patients |
| MRI Physician Associates, PC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Diagnostic Radiology Physician
- San Diego, CA
- NPI 1558463927
Neuroradiology
-
- Diagnostic Radiology Physician
- Philadelphia, PA
- NPI 1366501637
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191888000000",
"number": "1972685949",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9300 CAMPUS POINT DR",
"address_2": "MAIL CODE 7756",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "92037",
"telephone_number": "858-657-6650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9300 CAMPUS POINT DR",
"address_2": "7756",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "92037",
"telephone_number": "858-657-6650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "WADE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-19",
"last_updated": "2007-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "207LP2900X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pain Medicine",
"state": "CA",
"license": "20A3872",
"primary": false
},
{
"code": "2085N0700X",
"taxonomy_group": "",
"desc": "Radiology, Neuroradiology",
"state": "CA",
"license": "20A3872",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00AX38720",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in La Jolla, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.