JIMMIE WONG (NPI# 1003865866) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003865866 |
| Entity Type | Individual |
| Full Name | JIMMIE WONG |
| Credential | MD |
| Practice Address |
1500 Duarte Rd Duarte CA 91010-3012 |
| Mailing Address |
Po Box 512185 Los Angeles CA 90051-0185 |
| Practice Telephone | 6263598111 |
| Mailing Telephone | 6267753214 |
| Mailing Fax Number | 6262185310 |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2018-03-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
A91427 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00A914270 | 05 |
| Street Address |
1500 DUARTE RD |
| City | DUARTE |
| State | CA |
| Zip Code | 91010-3012 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861498271 | Marwan G Fakih | Internal Medicine | 1500 Duarte Rd, Duarte, CA 91010-3012 | 2005-06-22 |
| 1801403688 | Jia-chi Wang | Medical Genetics | 1500 Duarte Rd, Duarte, CA 91010-3012 | 2020-09-25 |
| 1053923300 | Ying Moua | Social Worker | 1500 Duarte Rd, Duarte, CA 91010-3000 | 2020-08-18 |
| 1477163814 | Elise Sobotka | Genetic Counselor, MS | 1500 Duarte Rd, Duarte, CA 91010-3012 | 2020-07-31 |
| 1033728217 | Gabriela Claudia Medrano | Nurse Practitioner | 1500 Duarte Rd, Duarte, CA 91010-3012 | 2020-07-23 |
| 1538783295 | Lynn Kim | Occupational Therapist | 1500 Duarte Rd, Duarte, CA 91010-3012 | 2020-05-29 |
| 1235759887 | Jessica Vuong | Pharmacist | 1500 Duarte Rd, Duarte, CA 91010-3012 | 2020-04-23 |
| 1073133104 | Edward Thanasombat | Pharmacist | 1500 Duarte Rd, Duarte, CA 91010-3012 | 2020-04-18 |
| 1285254300 | Tu Nguyen Doan Vuong | Pharmacist | 1500 Duarte Rd, Duarte, CA 91010-3012 | 2020-04-18 |
| 1093344756 | Amy Marie Mcgovern | Nurse Practitioner | 1500 Duarte Rd, Duarte, CA 91010-3012 | 2020-04-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386266849 | Cheyenne King | Student in an Organized Health Care Education/Training Program | 1801 Huntington Drive, Duarte, Ca 91010, Duarte, CA 91010 | 2020-05-07 |
| 1114578028 | Cristian Gonzalez | Case Manager/Care Coordinator | 2250 E Foothill Ave, Pasadena, CA 91010 | 2019-09-23 |
| 1366932378 | Maisie Madrid | Marriage & Family Therapist | 1801 Huntington Drive, Duarte, CA 91010 | 2018-05-15 |
| 1598289571 | Bertha Maria Torres | Social Worker | 938 E. Huntington Drive, Unit A, Duarte, CA 91010 | 2017-08-01 |
| 1598292286 | Sheila Ramirez | Occupational Therapy Assistant | 2302 Citrus View Ave, Duarte, CA 91010 | 2017-05-12 |
| 1982059556 | Patricia Mendoza | Case Manager/Care Coordinator | 2502 E.huntington Dr., Duarte, CA 91010 | 2016-05-02 |
| 1770966178 | Sinziana Dumitra | Surgery | 1500 Durate Road California, Mob L001, Duarte, CA 91010 | 2015-07-02 |
| 1477940161 | Jin Sun L Bitar | Internal Medicine | 1500 Duarte Rd # Wing4, Duarte, CA 91010 | 2015-04-20 |
| 1659625622 | Jeanette Marie Petermann | Nurse Practitioner | 1036 East Huntington Drive, Duarte, CA 91010 | 2012-10-30 |
| 1649534397 | Nathaniel J Khoe Dds. Inc | Dentist | 1016 Huntington Drive, Duarte, CA 91010 | 2012-06-27 |
| Find all providers in zip 91010 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437190915 | Shana M Landau | Radiology | 1500 E Duarte Road, Duarte, CA 91010-3012 | 2006-06-08 |
| 1437582772 | Saro Berj Manoukian | Radiology | 1500 Duarte Rd, Duarte, CA 91010-3012 | 2013-08-09 |
| 1902197254 | Mari Bozoghlanian | Radiology | 1500 E Duarte Rd, Helford Hospital, Rm 1300, Duarte, CA 91010 | 2011-04-20 |
| 1255621462 | Ammar Ahmed Chaudhry | Radiology | 1500 Duarte Rd, Duarte, CA 91010-3012 | 2011-04-10 |
| 1962791582 | Jonathan Young | Radiology | 1500 E. Duarte Road, Duarte, CA 91010 | 2011-04-04 |
| 1982913794 | Pejman Moshe Motarjem | Radiology | 1500 Duarte Rd, Duarte, CA 91010-3012 | 2010-09-28 |
| 1396050365 | Mariko Fitzgibbons | Radiology | 1500 Duarte Rd, Duarte, CA 91010-3012 | 2010-08-13 |
| 1982922910 | Lusine Tumyan | Radiology | 1500 Duarte Rd, Duarte, CA 91010 | 2010-05-14 |
| 1588981914 | Violetta S Karpova | Radiology | 1500 E Duarte Road, Duarte, CA 91010-3012 | 2010-04-25 |
| 1285766006 | Alexander Solomon Jung | Radiology | 1500 Duarte Rd, Duarte, CA 91010-3012 | 2007-03-09 |
| Find all providers in DUARTE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.