Provider Demographics
NPI:1013924448
Name:WONG, HUBERT K (MD)
Entity Type:Individual
Prefix:DR
First Name:HUBERT
Middle Name:K
Last Name:WONG
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2225 PORT CHICAGO HWY
Mailing Address - Street 2:SUITE 444
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-2051
Mailing Address - Country:US
Mailing Address - Phone:925-689-7744
Mailing Address - Fax:925-689-7748
Practice Address - Street 1:350 30TH ST
Practice Address - Street 2:SUITE 444
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3424
Practice Address - Country:US
Practice Address - Phone:510-832-8080
Practice Address - Fax:510-832-8081
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2017-03-06
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Provider Licenses
StateLicense IDTaxonomies
CAG41626207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G416260Medicaid
CA00G416260Medicaid
CA00G416260Medicare PIN