| Lydia Chin Wong, DO | |
|
5 Centerpointe Dr, La Palma, CA 90623-1050 | |
| (833) 574-2273 | |
| Not Available |
| Full Name | Lydia Chin Wong |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 5 Centerpointe Dr, La Palma, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275169245 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 20A21140 (California) | Primary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| Entity Name | Southern California Permanente Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770515280 PECOS PAC ID: 6002729175 Enrollment ID: O20031110000678 |
| Mailing Address | Practice Location Address |
|---|---|
| Lydia Chin Wong, DO 226 Chorus, Irvine, CA 92618-1413 Ph: () - | Lydia Chin Wong, DO 5 Centerpointe Dr, La Palma, CA 90623-1050 Ph: (833) 574-2273 |
Dr. Albert Y.d. Lee, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 7872 Walker St, Suite 100, La Palma, CA 90623 Phone: 714-522-4009 | |
Dr. Jong In Lee, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 5471 La Palma Ave Ste 205, La Palma, CA 90623 Phone: 714-521-6690 Fax: 714-521-9367 | |
Guity N Yeganeh, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 5 Centerpoint Dr., La Palma, CA 90623 Phone: 714-562-3420 |