Provider Demographics
NPI:1265463442
Name:WONG, DON F (MD)
Entity Type:Individual
Prefix:DR
First Name:DON
Middle Name:F
Last Name:WONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:980 TRANCAS ST STE 4
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-2933
Mailing Address - Country:US
Mailing Address - Phone:707-253-7337
Mailing Address - Fax:707-253-1288
Practice Address - Street 1:980 TRANCAS ST STE 4
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-2933
Practice Address - Country:US
Practice Address - Phone:707-253-7337
Practice Address - Fax:707-253-1288
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG40577208000000X, 2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatrics
Not Answered2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF15083Medicare UPIN
CAG405771Medicare ID - Type Unspecified