Physician Compare National (NPI:1255383683)

HEALTHCARE PROVIDER: ROBIN L WONG M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1255383683
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9830383132
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101105001137
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	WONG
	Individual professional last name
Provider First Name	ROBIN
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1975
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	GENERAL SURGERY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	GENERAL SURGERY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	2003 N CALIFORNIA ST
	Group Practice or individual's line 1 address
City	STOCKTON
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	952046006
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	050084
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST JOSEPHS MEDICAL CENTER OF STOCKTON
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y