| Calvin K. Wong, Md, Pc | |
|
5471 Kearny Villa Rd Suite 200 San Diego CA 92123-1143 | |
| (858) 571-0606 | |
| (858) 571-1933 |
| Full Name | Calvin K. Wong, Md, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 5471 Kearny Villa Rd, San Diego, California |
| Authorized Official Name and Position | Calvin K. Wong (PRESIDENT) |
| Authorized Official Contact | 8585710606 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Calvin K. Wong, Md, Pc 5471 Kearny Villa Rd Suite 200 San Diego CA 92123-1143 Ph: (858) 571-0606 | Calvin K. Wong, Md, Pc 5471 Kearny Villa Rd Suite 200 San Diego CA 92123-1143 Ph: (858) 571-0606 |
| NPI Number | 1679790232 |
|---|---|
| Provider Enumeration Date | 04/18/2007 |
| Last Update Date | 04/19/2010 |
| Medicare PECOS PAC ID | 9436250818 |
|---|---|
| Medicare Enrollment ID | O20070730000467 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679790232 | NPI | - | NPPES |
| G79819 | Other | MEDICARE GROUP NUMBER | |
| WG79819C | Other | MEDICARE PROVIDER ID | |
| G79819 | Other | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | G79819 (California) | Primary |
| Provider Name | Calvin K Wong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962400531 PECOS PAC ID: 4688571284 Enrollment ID: I20031212000574 |
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