Healthcare Provider Details

I. General information

NPI: 1356258164
Provider Name (Legal Business Name): JOSHUA CHENG BIN WONG PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 N HILLSIDE ST
WICHITA KS
67214-3219
US

IV. Provider business mailing address

1940 S WOODLAWN BLVD APT 116
WICHITA KS
67218-4746
US

V. Phone/Fax

Practice location:
  • Phone: 316-616-3333
  • Fax:
Mailing address:
  • Phone: 701-730-2164
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: