Provider Demographics
NPI:1356477079
Name:WONG, PAUL WING-YIU (DC)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:WING-YIU
Last Name:WONG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 W VALLEY BLVD
Mailing Address - Street 2:STE. 207
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91803-2462
Mailing Address - Country:US
Mailing Address - Phone:626-282-1106
Mailing Address - Fax:626-282-1226
Practice Address - Street 1:1101 W VALLEY BLVD
Practice Address - Street 2:STE. 207
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91803-2462
Practice Address - Country:US
Practice Address - Phone:626-282-1106
Practice Address - Fax:626-282-1226
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15076111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT17970Medicare UPIN
CADC15076AMedicare ID - Type Unspecified