DR. GREGORY SAN WONG MD NPI 1336294875

NPI Information

NPI: 1336294875
Provider Name: DR. GREGORY SAN WONG, MD
Classification: Internal Medicine - 207RG0300X
Entity Type: Individual

Specialization: Geriatric Medicine

PECOS Registration: Yes

Address:
1700 CESAR CHAVEZ AVE
SENIOR CARE CLINIC
LOS ANGELES, CA
ZIP 90033
Phone: (323) 307-0800
Get Directions

DR. Gregory San Wong, MD is a geriatric medicine internal medicine in Los Angeles, CA. The provider is an internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. DR. Gregory San Wong, MD NPI is 1336294875. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1700 CESAR CHAVEZ AVE
SENIOR CARE CLINIC
LOS ANGELES, CA
ZIP 90033-414
Phone: (323) 307-0800
Fax: (323) 307-0803

The NPI 1336294875 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 1/24/2007 and was last updated on 10/1/2009.

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	207RG0300X	Internal Medicine	Geriatric Medicine	A96833	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00A968330	MEDICAID	CALIFORNIA
2	AW165Z	MEDICARE UPIN	CALIFORNIA

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: 4/28/2024

NPI Synchronization or Removal

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