Physician Compare National (NPI:1740445279)

HEALTHCARE PROVIDER: PATRICK WONG JR. D.O

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

Individual Professional Information
NPI	1740445279
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8022248632
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20171102000740
	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	PATRICK
	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
Primary Specialty	CRITICAL CARE (INTENSIVISTS)
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	PULMONARY AND CRITICAL CARE ASSOCIATES OF MODESTO INC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	8820393523
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	4
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1441 FLORIDA AVE
	Group Practice or individual's line 1 address
City	MODESTO
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	953504404
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	050464
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	DOCTORS MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	050179
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	EMANUEL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y