Phillip C Wong (NPI# 1467489674, PAC ID# 3173553021) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DIAGNOSTIC RADIOLOGY.
| Nation Provider ID (NPI) | 1467489674 |
| PAC ID by PECOS | 3173553021 |
| Professional Enrollment ID | I20060720000136 |
| Full Name | Phillip C Wong |
| Organization Legal Name | SOLANO DIAGNOSTICS PARTNERS, A CALIF LIMITED PARTNERSHIP |
| Address |
108 Fernwood Dr Moraga CA 94556-2316 |
| Phone Number | 7076464646 |
| Gender | M |
| Credential | MD |
| Medical School | STATE UNIVERSITY OF NEW YORK AT STONY BROOK, SCHOOL OF MEDICINE |
| Graduation Year | 2000 |
| Primary Specialty | DIAGNOSTIC RADIOLOGY |
| Group Practice PAC ID | 4587556865 |
| Number of Group Practice Members | 26 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 050043 | ALTA BATES SUMMIT MEDICAL CENTER |
| 050488 | EDEN MEDICAL CENTER |
| 050305 | ALTA BATES SUMMIT MEDICAL CENTER - ALTA BATES CAMP |
| 050013 | ADVENTIST HEALTH ST HELENA |
| 050101 | SUTTER SOLANO MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 2450 Ashby Ave, Berkeley, CA 94705-2067 | 5102041566 | BAY IMAGING CONSULTANTS MEDICAL GROUP INC |
| 108 Fernwood Dr, Moraga, CA 94556-2316 | 7076464646 | SOLANO DIAGNOSTICS PARTNERS, A CALIF LIMITED PARTNERSHIP |
| 5730 Telegraph Ave, Oakland, CA 94609-1710 | 5102042744 | MAGNETIC IMAGING AFFILIATES LLC |
| 6080 Contra Costa Rd, Oakland, CA 94618-2139 | 7076464646 | SOLANO DIAGNOSTICS PARTNERS, A CALIF LIMITED PARTNERSHIP |
| Organization Legal Name | SOLANO DIAGNOSTICS PARTNERS, A CALIF LIMITED PARTNERSHIP |
| Physicians | 23 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Shilpa Puppala | Diagnostic Radiology | Solano Diagnostics Partners, A Calif Limited Partnership | 1100 B Gale Wilson Blvd, Solano Diagnostics Imaging Medical Group, Fairfield, CA 94533-3700 |
| Kathryn A Klima | Diagnostic Radiology | Solano Diagnostics Partners, A Calif Limited Partnership | 1101 B Gale Wilson Blvd, Suite 100, Fairfield, CA 94533-3771 |
| Vincent Kw Wong | Diagnostic Radiology | Solano Diagnostics Partners, A Calif Limited Partnership | 20 Garden Estates Ct, Alamo, CA 94507-1129 |
| Christopher Ct Lee | Diagnostic Radiology | Solano Diagnostics Partners, A Calif Limited Partnership | 900 Bronson Ln, Walnut Creek, CA 94596-5465 |
| George D Chu | Diagnostic Radiology | Solano Diagnostics Partners, A Calif Limited Partnership | 40 Neva Ct, Oakland, CA 94611-1827 |
| Ying Fung | Diagnostic Radiology | Solano Diagnostics Partners, A Calif Limited Partnership | 871 Lawton St, San Francisco, CA 94122-3541 |
| Stephen M Hesseltine | Diagnostic Radiology | Solano Diagnostics Partners, A Calif Limited Partnership | 108 Fernwood Dr, Moraga, CA 94556-2316 |
| Michael John Martinucci | Diagnostic Radiology | Solano Diagnostics Partners, A Calif Limited Partnership | 9062 Broadway Ter, Oakland, CA 94611-1952 |
| David Howard | Diagnostic Radiology | Solano Diagnostics Partners, A Calif Limited Partnership | 4016 Eagle Nest Ln, Danville, CA 94506-5810 |
| Keith M Tao | Diagnostic Radiology | Solano Diagnostics Partners, A Calif Limited Partnership | 4442 Deer Field Way, Danville, CA 94506-6015 |
| Street Address |
108 FERNWOOD DR |
| City | MORAGA |
| State | CA |
| Zip | 94556-2316 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Stephen M Hesseltine | Diagnostic Radiology | Solano Diagnostics Partners, A Calif Limited Partnership | 108 Fernwood Dr, Moraga, CA 94556-2316 |
| John Henry Vanuden | Diagnostic Radiology | Solano Diagnostics Partners, A Calif Limited Partnership | 108 Fernwood Dr, Moraga, CA 94556-2316 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michelle Simi | Family Practice | 1100 Moraga Way, Suite 108, Moraga, CA 94556-1153 | |
| Andre Westin | Hospitalist | 348 Rheem Blvd, Moraga, CA 94556-1516 | |
| William E Schwertscharf | Optometry | 1030 Country Club Dr A, Moraga, CA 94556-1950 |
| City | MORAGA |
| Zip Code | 94556 |
| Specialty | DIAGNOSTIC RADIOLOGY |
| City + Specialty | MORAGA + DIAGNOSTIC RADIOLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.