Wong, Wade

Wong, Wade is an individual health care provider with primary practice located at 9300 Campus Point Dr 7756, La Jolla CA 92037. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pain Medicine, Allopathic & Osteopathic Physicians / Neuroradiology. Allopathic & Osteopathic Physicians / Neuroradiology is his primary health care specialty. Wong, Wade can be contacted via phone (858) 657-6650.

Contact Information

Primary practice address
9300 Campus Point Dr 7756 La Jolla CA 92037
Phone: (858) 657-6650
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X 20A3872 California
Allopathic & Osteopathic Physicians / Neuroradiology 2085N0700X 20A3872 California

Profile Details

NPI number 1972685949
LBN Legal business name Wong, Wade
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 19th, 2006
Last updated Oct 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972685949 NPPES
California MEDICAID 00AX38720

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