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General NPI Number Information
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NPI Number | 1245874775
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Entity Type | Individual
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Provider Name | DAWN WONG PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/28/2019
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 3651 COLLEGE BLVD STE 200
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City | LEAWOOD
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State | KS
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Zip | 66211-1910
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Country | US
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Telephone | 913-319-7633
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Fax |
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Provider Business Mailing Address
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Address Line | 3651 COLLEGE BLVD
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City | LEAWOOD
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State | KS
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Zip | 66211-1910
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Country | US
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Telephone | 913-319-7633
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 15-02986
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 56845
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License Number State | CA
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