Provider Demographics
NPI:1447243811
Name:WY, TOMAS WONG (MD)
Entity Type:Individual
Prefix:
First Name:TOMAS
Middle Name:WONG
Last Name:WY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:TOMAS
Other - Middle Name:
Other - Last Name:WY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:300 N SAN ANTONIO RD
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93110-1316
Mailing Address - Country:US
Mailing Address - Phone:805-681-5461
Mailing Address - Fax:
Practice Address - Street 1:931 WALNUT AVE
Practice Address - Street 2:
Practice Address - City:CARPINTERIA
Practice Address - State:CA
Practice Address - Zip Code:93013-2028
Practice Address - Country:US
Practice Address - Phone:805-560-1050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC51576207QA0505X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G37417Medicare UPIN
G37417Medicare UPIN
311155352OtherEV BENEFITS
311155352OtherEMERALD HEALTH
OHWY2022352Medicare ID - Type UnspecifiedMCARTHUR OHIO OFFICE
OHWY2022353Medicare ID - Type UnspecifiedCHILLICOTHE OHIO OFFICE
0104961OtherUNITED HEALTHCARE
OH2152950Medicaid
311155352OtherGREAT WEST
311155352OtherNATIONWIDE INS.
OH311155352OtherOHIO HEALTH CHOICE
311155352OtherPPO NEXT
OHWY2022351Medicare ID - Type UnspecifiedNEW LEXINGTON OHIO OFFICE
311155352OtherTRICARE
OH311155352OtherCENTRAL BENEFITS
311155352OtherCIGNA/CONN. GEN