Active NPI
Tina Lai Wong, M.D.
- Pediatrics Physician
- West Covina, CA
National Provider Identifier
1982093761
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- A71135
- Practice address
- 2657 E Charlinda St
West Covina, CA 91791-2901 - Phone
- (626) 864-2997
- NPI assigned
- Jan 15, 2015
- Last updated
- Jan 15, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 | A71135 | CA | Primary |
Addresses
Primary practice location
2657 E Charlinda St
West Covina, CA 91791-2901
Mailing address
2657 E Charlinda St
West Covina, CA 91791-2901
Phone (626) 864-2997
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 |
|---|---|---|---|
| A71135 | CA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421280000000",
"number": "1982093761",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2657 E CHARLINDA ST",
"city": "WEST COVINA",
"state": "CA",
"postal_code": "917912901",
"telephone_number": "626-864-2997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2657 E CHARLINDA ST",
"city": "WEST COVINA",
"state": "CA",
"postal_code": "917912901",
"telephone_number": "626-864-2997"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "TINA",
"middle_name": "LAI",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-01-15",
"last_updated": "2015-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A71135",
"primary": true
}
],
"identifiers": [],
"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 Jan 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.