DR. DEREK ALAN WONG (NPI# 1134199946) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134199946 |
| Entity Type | Individual |
| Full Name | DR. DEREK ALAN WONG |
| Credential | M.D. |
| Practice Address |
10833 Leconte Ave Mdcc 12-334 Los Angeles CA 90095-1732 |
| Practice Telephone | 3102066581 |
| Practice Fax Number | 3102068616 |
| Mailing Telephone | 3102066581 |
| Mailing Fax Number | 3102068616 |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2015-01-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207SG0201X |
Medical Genetics Specialization: Clinical Genetics (M.D.) |
G73118 | CA | Allopathic & Osteopathic Physicians |
| N | 207SG0202X |
Medical Genetics Specialization: Clinical Biochemical Genetics |
G73118 | CA | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | G73118 | CA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285286211 | Derek Wei-yun Wong | Behavior Technician | 1520 Pershing Dr Apt F, San Francisco, CA 94129-1096 | 2019-07-10 |
| 1427367135 | Derek Wong | Dentist | 2480 Howard Ave, San Carlos, CA 94070-4415 | 2010-09-29 |
| 1245464999 | Derek Wong | Dentist | 826 N Monterey St Apt A, Alhambra, CA 91801-6425 | 2009-05-11 |
| 1356961338 | Derek Wong | Occupational Therapist | 35 Escuela Dr, Daly City, CA 94015-4003 | 2020-04-20 |
| 1811475858 | Derek Wong | Behavior Technician | 41521 W 11 Mile Rd, Novi, MI 48375-1803 | 2018-08-01 |
| 1114374782 | Derek Wong | Internal Medicine | 425 W 5th St, East Liverpool, OH 43920-2405 | 2016-05-24 |
| 1912280058 | Derek L Wong | Pharmacist | 8302 Old Sauk Rd, Middleton, WI 53562-4404 | 2011-09-26 |
| 1710218599 | Derek J Wong | Obstetrics & Gynecology | 1 Scripps Dr Ste 107, Sacramento, CA 95825-6206 | 2010-01-19 |
| Street Address |
10833 LECONTE AVE MDCC 12-334 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90095-1732 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548664089 | Susana Pak Chae | Nurse Anesthetist, Certified Registered | 10833 Leconte Ave, Room 56-142 Chs, Los Angeles, CA 90095-0001 | 2014-10-13 |
| 1871929570 | Suzanne Hollander | Dietitian, Registered | 10833 Leconte Ave, Mdcc 12-334, Los Angeles, CA 90095-0001 | 2013-09-25 |
| 1952604613 | Elise Marie Martin | Internal Medicine | 10833 Leconte Ave, 37-121 Chs, Los Angeles, CA 90095-0001 | 2010-12-17 |
| 1407162381 | Gil B Ivry | Dentist | 10833 Leconte Ave, A0-156 Chs, Los Angeles, CA 90095-0001 | 2010-08-30 |
| 1922323856 | Grace Deukmedjian | Pediatrics | 10833 Leconte Ave, Suite 265, Los Angeles, CA 90095-0001 | 2010-04-04 |
| 1376784678 | Negar Khanlou | Pathology | 10833 Leconte Ave, Box 951732, A7-149 Chs Box 116, Los Angeles, CA 90095-0001 | 2009-03-16 |
| 1235397902 | Neil A Martin, Md, Inc | Neurological Surgery | 10833 Leconte Ave, Los Angeles, CA 90095-0001 | 2008-05-29 |
| 1942468624 | John G Frazee Md A Professional Corporation | Neurological Surgery | 10833 Leconte Ave, Los Angeles, CA 90095-0001 | 2008-05-29 |
| 1508031881 | Stacie Lynn Schurman | Advanced Practice Midwife | 10833 Leconte Ave, Los Angeles, CA 90095-0001 | 2008-04-28 |
| 1316121221 | Irene Tam | Dentist | 10833 Leconte Ave, Los Angeles, CA 90095-0001 | 2007-12-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982212155 | Alexandra Gubin | Social Worker | Ucla, 757 Westwood Medical Plaza, Los Angeles, CA 90095 | 2020-07-14 |
| 1952926263 | Georgina Parra | Student in an Organized Health Care Education/Training Program | 10833 Le Conteave, Los Angeles, CA 90095 | 2020-06-11 |
| 1609403575 | Yagmur Muftuoglu | Student in an Organized Health Care Education/Training Program | 757 Westwood Plaza, Neurosurgery, Los Angeles, CA 90095 | 2020-03-23 |
| 1619438173 | Brandon Covington Smith | Student in an Organized Health Care Education/Training Program | 727 Westwood Plaza, Dept of Internal Medicine, Los Angeles, CA 90095 | 2019-03-27 |
| 1184184913 | Alexander Daniel Yuen | Student in an Organized Health Care Education/Training Program | 757 Westwood Plaza (internal Medicine), Los Angeles, CA 90095 | 2019-03-19 |
| 1790266369 | Dana Saifan | Student in an Organized Health Care Education/Training Program | 1000 Veteran Avenue, Los Angeles, CA 90095 | 2018-08-22 |
| 1427549146 | Courtney Renee' Real | Registered Nurse | 757 Westwood Plz Ste 6236, Los Angeles, CA 90095 | 2018-05-29 |
| 1932605094 | Akash Atul Shah | Student in an Organized Health Care Education/Training Program | Ucla Department of Orthopaedic Surgery, 10833 Le Conte Avenue, 76-116 Chs, Los Angeles, CA 90095 | 2018-04-05 |
| 1316443435 | Dane Jensen Brodke | Orthopaedic Surgery | 757 Westwood Plaza, (orthopaedic Surgery), Los Angeles, CA 90095 | 2018-04-05 |
| 1477058824 | Thomas William Gaither Castellanos | Student in an Organized Health Care Education/Training Program | 757 Westwood Plaza, Urology, Los Angeles, CA 90095 | 2018-03-28 |
| Find all providers in zip 90095 | ||||
| Taxonomy Code | 207SG0201X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Medical Genetics |
| Specialization | Clinical Genetics (M.D.) |
| A clinical geneticist demonstrates competence in providing comprehensive diagnostic, management and counseling services for genetic disorders. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Medical Genetics, 2007. http://www.abmg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Medical Genetics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164541181 | Matthew Deardorff | Medical Genetics | 4650 W Sunset Blvd # Ms 43, Los Angeles, CA 90027-6062 | 2007-03-29 |
| 1770618589 | Linda S Cowan | Medical Genetics | 1111 W 6th St Fl 2, Los Angeles, CA 90017-1800 | 2007-02-22 |
| 1568449122 | Shirley Rachel Korula | Medical Genetics | 4339 State University Dr, Diagnostic Center of Southern California, Los Angeles, CA 90032-4220 | 2005-12-27 |
| 1760765226 | Eyal M Reinstein | Medical Genetics | 8700 Beverly Blvd, Cedars Sinai Medical Center, Pact, Suite 400, Los Angeles, CA 90048 | 2011-09-21 |
| 1548548548 | Brandon Ross Colby | Medical Genetics | 10780 Santa Monica Blvd, Suite 360, Los Angeles, CA 90025-4749 | 2011-07-26 |
| 1922305036 | Linda S. Cowan, Md A Professional Corporation | Medical Genetics | 637 Lucas Ave, #205, Los Angeles, CA 90017-1912 | 2011-02-25 |
| 1306076039 | Alvaro H Serrano Russi | Medical Genetics | 4650 Sunset Blvd, Los Angeles, CA 90027-6062 | 2009-07-15 |
| 1962688853 | Sridevi Abboy | Medical Genetics | 4760 W Sunset Blvd, Los Angeles, CA 90027-6063 | 2008-01-10 |
| 1891995122 | Moin U Vera | Medical Genetics | 4650 W Sunset Blvd, Los Angeles, CA 90027 | 2007-07-24 |
| 1922206572 | University Childrens Medical Group | Medical Genetics | 4650 W Sunset Blvd, Ms# 90, Los Angeles, CA 90027-6062 | 2007-07-05 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90095 |
Please comment or provide details below to improve the information on DR. DEREK ALAN WONG.
| 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.