| Shi Yin Wong Md, A Medical Corporation | |
|
407 W College St Los Angeles CA 90012-2313 | |
| (213) 626-3589 | |
| (213) 626-7868 |
| Full Name | Shi Yin Wong Md, A Medical Corporation |
|---|---|
| Speciality | General Practice |
| Location | 407 W College St, Los Angeles, California |
| Authorized Official Name and Position | Shi Yin Wong (OWNER) |
| Authorized Official Contact | 2136263589 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shi Yin Wong Md, A Medical Corporation 407 W College St Los Angeles CA 90012-2313 Ph: (213) 626-3589 | Shi Yin Wong Md, A Medical Corporation 407 W College St Los Angeles CA 90012-2313 Ph: (213) 626-3589 |
| NPI Number | 1619029964 |
|---|---|
| Provider Enumeration Date | 01/17/2007 |
| Last Update Date | 11/16/2010 |
| Medicare PECOS PAC ID | 1850444886 |
|---|---|
| Medicare Enrollment ID | O20090807000623 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619029964 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | G34772 (California) | Primary |
| Provider Name | Shi-yin Wong |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1902986920 PECOS PAC ID: 0941297923 Enrollment ID: I20090807000616 |
| Provider Name | Jethro J Esguerra |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285945576 PECOS PAC ID: 0648435339 Enrollment ID: I20120710000543 |
| Provider Name | Emmeline Chan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841636784 PECOS PAC ID: 3971733734 Enrollment ID: I20140224001161 |
| Provider Name | Kimberly Chan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295166692 PECOS PAC ID: 6800110487 Enrollment ID: I20150131000153 |
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