DR. GRANGER BRADFORD WONG (NPI# 1225013790) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225013790 |
| Entity Type | Individual |
| Full Name | DR. GRANGER BRADFORD WONG |
| Credential | MD,DMD,FACS |
| Practice Address |
2221 Stockton Blvd Sacramento CA 95817-1418 |
| Practice Telephone | 9167342130 |
| Mailing Telephone | 9167342130 |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2014-03-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 170100000X | Medical Genetics, Ph.D. Medical Genetics | A54333 | CA | Other Service Providers |
| Y | 208200000X | Plastic Surgery | A54333 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
2221 STOCKTON BLVD |
| City | SACRAMENTO |
| State | CA |
| Zip Code | 95817-1418 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427041698 | Regents of The Univ of Ca | Surgery | 2221 Stockton Blvd, Sacramento, CA 95817 | 2005-08-23 |
| 1770127334 | Andrew Thompson | Nurse Practitioner | 2221 Stockton Blvd, Sacramento, CA 95817-1418 | 2019-11-06 |
| 1982187241 | Kimberly C Sosik | Physician Assistant | 2221 Stockton Blvd, Sacramento, CA 95817-1418 | 2018-09-12 |
| 1285132175 | Gerdy Mirline Pluviose | Nurse Practitioner | 2221 Stockton Blvd, Sacramento, CA 95817-1418 | 2018-01-25 |
| 1649704610 | Dana Tam Kilday | Nurse Practitioner | 2221 Stockton Blvd, Sacramento, CA 95817-1418 | 2017-04-17 |
| 1912458860 | Jenny Mccormack | Nurse Practitioner | 2221 Stockton Blvd, Sacramento, CA 95817-1418 | 2016-10-16 |
| 1013367135 | Amir Sarkeshik | Student in an Organized Health Care Education/Training Program | 2221 Stockton Blvd, Sacramento, CA 95817-1418 | 2016-06-20 |
| 1134593783 | Allison Shuken | Nurse Practitioner | 2221 Stockton Blvd, Sacramento, CA 95817-1418 | 2015-11-19 |
| 1801277751 | Sean James Judge | Student in an Organized Health Care Education/Training Program | 2221 Stockton Blvd, Sacramento, CA 95817-1418 | 2015-06-17 |
| 1215329396 | Bernadette Hystad | Physician Assistant | 2221 Stockton Blvd, 2112, Sacramento, CA 95817-1418 | 2015-02-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346855103 | Quintin Kuse | Student in an Organized Health Care Education/Training Program | 4610 X Street, Sacramento, Sacramento, CA 95817 | 2020-09-09 |
| 1285259283 | Uc Davis Health | Dietitian, Registered | 2315 Stockton Blvd Sesp 0160, Sacramento, CA 95817 | 2020-06-15 |
| 1942840558 | Michael Marchand-gareau | Ophthalmology | Michael Marchand - Uc Davis Eye Center, 4860 Y Street, Suite 2400, Sacramento, CA 95817 | 2020-01-11 |
| 1467010728 | Jiunn Liang Jonathan Yap | Student in an Organized Health Care Education/Training Program | 4860 Y Str, Ste. 2820, Sacramento, CA 95817 | 2019-06-03 |
| 1083176614 | Kevin Lee | Student in an Organized Health Care Education/Training Program | 2315 Stockton Blvd, Op512, Sacramento, CA 95817 | 2019-04-02 |
| 1508326703 | Ritika Johal | Student in an Organized Health Care Education/Training Program | 4150 V Street, Pssb 1200, Sacramento, CA 95817 | 2019-03-22 |
| 1811468838 | Paige Palsgaard | Behavior Technician | 6730 4th Ave Apt 1731d, Sacramento, CA 95817 | 2018-12-17 |
| 1922503408 | Marie Rossi | Student in an Organized Health Care Education/Training Program | 4150 V Street #1100, Sacramento, CA 95817 | 2018-03-27 |
| 1639673791 | Sean Lam | Student in an Organized Health Care Education/Training Program | 4150 V Street #1200, Sacramento, CA 95817 | 2018-03-22 |
| 1124555388 | Tatyana Polyak | Surgery | 2335 Stockton Blvd., Naob 6th Floor, Sacramento, CA 95817 | 2017-05-18 |
| Find all providers in zip 95817 | ||||
| Taxonomy Code | 208200000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Plastic Surgery |
| A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215357215 | Sanam Zahedi | Plastic Surgery | 2221 Stockton Blvd Ste 1100, Sacramento, CA 95817-1418 | 2014-04-17 |
| 1013215946 | James Patrick Hamill | Plastic Surgery | 1031 Wilhaggin Park Ln, Sacramento, CA 95864-5376 | 2011-03-01 |
| 1629303177 | Chetan Shawn Irwin | Plastic Surgery | Shriners Hospital of Children - Northern California, 2425 Stockton Blvd., Suite 517, Sacramento, CA 95817-2215 | 2009-10-15 |
| 1982861753 | Joseph R. Coscia | Plastic Surgery | 95 Scripps Drive, Sacramento, CA 95825-6320 | 2008-05-20 |
| 1952451759 | Jack G Bruner | Plastic Surgery | 2801 K St Ste 200, Sacramento, CA 95816-5118 | 2007-01-12 |
| 1558433573 | Donald Richard Jasper | Plastic Surgery | 95 Scripps Dr, Sacramento, CA 95825-6320 | 2006-11-14 |
| 1992883664 | Charles W. Perry | Plastic Surgery | 785 University Ave, Chrysalis Cosmetics, Sacramento, CA 95825-6708 | 2006-11-01 |
| 1629034558 | Lee L. Q. Pu | Plastic Surgery | 2221 Stockton Blvd., First Floor, Sacramento, CA 95817 | 2006-04-20 |
| 1669880548 | Peter Kwan | Plastic Surgery | 2425 Stockton Blvd, Office 718, Sacramento, CA 95817-2215 | 2014-07-23 |
| 1730452525 | Maria Chacon Gomez | Plastic Surgery | 2425 Stockton Blvd, Sacramento, CA 95817-2215 | 2012-02-10 |
| Find all providers in SACRAMENTO | ||||
| City | SACRAMENTO |
| Zip Code | 95817 |
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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.