Provider Demographics
NPI:1750483079
Name:WONG, HANSON PAO-SANG (MD)
Entity Type:Individual
Prefix:DR
First Name:HANSON
Middle Name:PAO-SANG
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 1:10230 ARTESIA BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-6763
Mailing Address - Country:US
Mailing Address - Phone:562-804-7223
Mailing Address - Fax:562-804-0165
Practice Address - Street 1:10230 ARTESIA BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-6763
Practice Address - Country:US
Practice Address - Phone:562-804-7223
Practice Address - Fax:562-804-0165
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2008-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG63718207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0071090Medicaid
CAW13907Medicare ID - Type Unspecified
CAGR0071090Medicaid