Jair Wong, Md, Inc | |
1535 W Merced Ave Suite #102 West Covina CA 91790 | |
(626) 962-9108 | |
(626) 960-7337 |
Full Name | Jair Wong, Md, Inc |
---|---|
Speciality | Internal Medicine |
Location | 1535 W Merced Ave, West Covina, California |
Authorized Official Name and Position | Jair Wong (PRESIDENT) |
Authorized Official Contact | 6269629108 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Jair Wong, Md, Inc 1535 W Merced Ave Suite #102 West Covina CA 91790 Ph: (626) 962-9108 | Jair Wong, Md, Inc 1535 W Merced Ave Suite #102 West Covina CA 91790 Ph: (626) 962-9108 |
NPI Number | 1396771960 |
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Provider Enumeration Date | 06/24/2006 |
Last Update Date | 06/06/2012 |
Medicare PECOS PAC ID | 8820062888 |
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Medicare Enrollment ID | O20040824001477 |
Identifier | Type | State | Issuer |
---|---|---|---|
1396771960 | NPI | - | NPPES |
WG75543F | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | G75543 (California) | Primary |
Provider Name | Jair Wong |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1972541266 PECOS PAC ID: 2365416328 Enrollment ID: I20040826000487 |
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