MICHAEL C WONG MD MEDICAL CORP (NPI# 1053532143) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053532143 |
| Entity Type | Organization |
| Organization Name | MICHAEL C WONG MD MEDICAL CORP |
| Other Organization Name | CALIFORNIA WOMENS MEDICAL CLINIC |
| Practice Address |
4282 Genesee Ave Suite 201 San Diego CA 92117-4964 |
| Practice Telephone | 8582680300 |
| Practice Fax Number | 8582683894 |
| Mailing Telephone | 8582680300 |
| Mailing Fax Number | 8582683894 |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2007-11-05 |
| Authorized Official Name | MICHAEL CHI WAI WONG (PRESIDENT) |
| Authorized Official Telephone | 8582680300 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | G34771 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0104370 | 05 | |
| CA | GR0104272 | 05 | |
| CA | GR0104271 | 05 |
| Other Name | Type Code |
|---|---|
| California Womens Medical Clinic | Doing Business As Name - Organization |
| Street Address |
4282 GENESEE AVE SUITE 201 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92117-4964 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033113600 | Michael C. Wong | Obstetrics & Gynecology | 4282 Genesee Ave, Ste 201, San Diego, CA 92117-4964 | 2005-06-10 |
| 1366791691 | Kathleen Alysia Grichar | Audiologist-Hearing Aid Fitter | 4282 Genesee Ave, Suite 301, San Diego, CA 92117-4946 | 2012-08-31 |
| 1144595000 | Yasuko Kidokoro Md A Professional Corporation | General Practice | 4282 Genesee Ave, Suite 202, San Diego, CA 92117-4989 | 2012-03-12 |
| 1083987051 | Marcia Elfenbaum, Md Inc. | Physical Medicine & Rehabilitation | 4282 Genesee Ave, Suite 304, San Diego, CA 92117-4963 | 2012-02-21 |
| 1619251899 | Bryan L Abramowitz, Md Inc. | Non-Pharmacy Dispensing Site | 4282 Genesee Ave, 302, San Diego, CA 92117-4946 | 2011-10-05 |
| 1477855989 | Natasha K. Fischang | Audiologist | 4282 Genesee Ave, Suite 301, San Diego, CA 92117-4946 | 2010-12-03 |
| 1508183765 | Yasuko Kidokoro Md A Professional Corporation | Clinic/Center | 4282 Genesee Ave, Suite 202, San Diego, CA 92117-4946 | 2010-04-28 |
| 1215109954 | Mendez Medical Center Inc | Pediatrics | 4282 Genesee Ave, Suite 201, San Diego, CA 92117 | 2008-04-01 |
| 1023130002 | San Diego Women's Medical Clinic, Inc. | Obstetrics & Gynecology | 4282 Genesee Ave, Suite 201, San Diego, CA 92117-4946 | 2007-04-03 |
| 1215078043 | Brian P. First, M.d., A Medical Corporation | Non-Pharmacy Dispensing Site | 4282 Genesee Ave, Suite 103, San Diego, CA 92117-4946 | 2007-02-12 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154956050 | Enbara Corporation | Dentist | 5189 Clairmont Mesa Blvd, San Diego, CA 92117 | 2020-03-11 |
| 1568956050 | Lourdes C Villagran | Case Manager/Care Coordinator | 4474 Charger Blvd, San Diego, CA 92117 | 2018-06-18 |
| 1750893509 | Dzendzel Family Chiropractic | Chiropractor | 3650 Clairemont Drive, Ste 2, San Diego, CA 92117 | 2017-11-02 |
| 1205355401 | Alan Ford | Counselor | 4150 Ute Dr., San Diego, CA 92117 | 2017-09-19 |
| 1780101238 | Allison Dawn Heeney | Occupational Therapist | 3386 Hopi Place, San Diego, CA 92117 | 2017-08-25 |
| 1275074379 | Rachel Gabrielle Packer | Counselor | 5252 Balboa Ave Ste 801, San Diego, CA 92117 | 2017-03-09 |
| 1316482995 | Lisa Graff-marsh, Inc. | Social Worker | 4985 Park Rim Dr., San Diego, CA 92117 | 2017-01-05 |
| 1417408949 | Markos and Markos 1 Inc | Private Vehicle | 4495 Clairemont Mesa Blvd, San Diego, CA 92117 | 2016-10-19 |
| 1801341813 | Huynh and Habashi Dental Corporation | Dentist | 2995 Clairemont Dr, Suite A, San Diego, CA 92117 | 2016-08-19 |
| 1184076077 | Tammy Monck | Optometrist | 3952 Clairemont Mesa Blvd Ste I, San Diego, CA 92117 | 2016-07-05 |
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| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316494768 | Samantha Berg | Obstetrics & Gynecology | 9339 Genesee Ave Ste 220, San Diego, CA 92121-2121 | 2016-09-01 |
| 1326495276 | Elizabeth Anne Coulter | Obstetrics & Gynecology | 200 West Arbor Drive, Mc8433, Ucsd Residency Office, San Diego, CA 92103 | 2016-05-20 |
| 1962889121 | Reproductive Sciences Medical Center | Obstetrics & Gynecology | 3661 Valley Centre Dr, Suite 100, San Diego, CA 92130-3321 | 2015-04-27 |
| 1134515695 | Tiffani Phan | Obstetrics & Gynecology | 550 Washington St Ste 331, San Diego, CA 92103-2227 | 2015-04-11 |
| 1437544251 | Lindsey Ann Burnett | Obstetrics & Gynecology | 200 West Arbor Drive, Mailcode 8433, University of California San Diego, San Diego, CA 92103 | 2015-03-30 |
| 1811240906 | Charles Hamrang | Obstetrics & Gynecology | 3250 Bunker Hill, San Diego, CA 92117 | 2012-10-26 |
| 1780955328 | Gerald M Spector | Obstetrics & Gynecology | 4045 Couts St, San Diego, CA 92103-1501 | 2012-01-12 |
| 1841578572 | L Dale Lapp M D Inc | Obstetrics & Gynecology | 4060 4th Ave Ste 640, San Diego, CA 92103-2118 | 2011-07-29 |
| 1114221603 | Leroy Albert Miller | Obstetrics & Gynecology | 2359 Juan Street, San Diego, CA 92103 | 2010-12-27 |
| 1154635415 | Robert J Santella, Md. Inc. | Obstetrics & Gynecology | 4531 College Ave, San Diego, CA 92115-4010 | 2010-07-28 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.