| Mr Dominic Tan Wong, GNP-BC | |
|
13652 Cantara St, Balboa Plaza Bldg, Panorama City, CA 91402-5423 | |
| (818) 832-7287 | |
| (818) 250-0061 |
| Full Name | Mr Dominic Tan Wong |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner |
| Location | 13652 Cantara St, Panorama City, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366472649 | NPI | - | NPPES |
| 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 |
| Entity Name | Meticulous Health Care Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1104570357 PECOS PAC ID: 1759757305 Enrollment ID: O20221021002486 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Dominic Tan Wong, GNP-BC 15971 Thompson Ranch Drive, Santa Clarita, CA 91387 Ph: (818) 288-2373 | Mr Dominic Tan Wong, GNP-BC 13652 Cantara St, Balboa Plaza Bldg, Panorama City, CA 91402-5423 Ph: (818) 832-7287 |
Gloria S Tongson, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 13652 Cantara St, Panorama City, CA 91402 Phone: 818-375-2000 | |
Tina J Woolfork, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 13652 Cantara St, Panorama City, CA 91402 Phone: 818-375-2000 | |
Mary Bernadette Acuna Coburn, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 13652 Cantara St, Panorama City, CA 91402 Phone: 818-375-2000 | |
Hilda Berenice Jacobo, FNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 8727 Van Nuys Blvd, Panorama City, CA 91402 Phone: 818-899-5555 | |
Sharon M Poncher, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 13652 Cantara St, Panorama City, CA 91402 Phone: 818-375-2000 | |
Velda C Mowry, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 13652 Cantara St, Panorama City, CA 91402 Phone: 818-375-2000 | |
Kristine Satenik Shahinyan, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 8012 Allott Ave, Panorama City, CA 91402 Phone: 323-422-8696 |