Provider Demographics
NPI:1023639176
Name:WONG, ARTHUR DANIEL WAI-YEN (MD)
Entity type:Individual
Prefix:
First Name:ARTHUR
Middle Name:DANIEL WAI-YEN
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 1:4222 KANSAS ST UNIT 2
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92104-1802
Mailing Address - Country:US
Mailing Address - Phone:747-218-8409
Mailing Address - Fax:
Practice Address - Street 1:4222 KANSAS ST UNIT 2
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92104-1802
Practice Address - Country:US
Practice Address - Phone:747-218-8409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-29
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA163178207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty