MS. SALLY KIM WONG PA-C NPI 1922105584

NPI Information

NPI: 1922105584
Provider Name: MS. SALLY KIM WONG, PA-C
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

Organization: PERMANENTE MEDICAL GROUP INC

PECOS Registration: Yes

Address:
975 SERENO DR
VALLEJO, CA
ZIP 94589
Phone: (707) 651-3470
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MS. Sally Kim Wong, PA-C is a surgical physician assistant in Vallejo, CA with 23 years of experience. MS. Sally Kim Wong, PA-C NPI is 1922105584. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

975 SERENO DR
VALLEJO, CA
ZIP 94589-441
Phone: (707) 651-3470
Fax: (707) 651-3484

The NPI 1922105584 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/17/2006 and was last updated on 1/3/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	PA15971	CALIFORNIA	No
2	363AS0400X	Physician Assistant	Surgical	PA15971	CALIFORNIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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