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NPI Code Detail

MEDICARE: MELANIE MY WONG

MEDICARE: MELANIE MY WONG
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant68190CA

General Provider Information

NPI Number : 1316806433
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELANIE MY WONG
Provider Business Mailing Address
First Line : PO BOX 43
Second Line :
City : SAN GABRIEL
State : CA
Zip : 91778-0043
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 525 E 12TH ST
Second Line :
City : OAKLAND
State : CA
Zip : 94606-2906
Country : US
Telephone Number : 800-607-6377
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2026
Last Update Date : 05/04/2026

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Directions to “ MELANIE MY WONG ” Practice Location

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