MEDICARE: DR. BENJAMIN H WONG MD

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
1	208000000X	Pediatrics Physician	15887	NV

General Provider Information

NPI Number	:	1275895997
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BENJAMIN H WONG MD

Provider Business Mailing Address
First Line	:	1701 W CHARLESTON BLVD STE 250
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-2325
Country	:	US
Telephone Number	:	702-671-2355
Fax Number	:

Provider Business Practice Location Address
First Line	:	3186 S MARYLAND PKWY
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89109-2306
Country	:	US
Telephone Number	:	702-961-5000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2012
Last Update Date	:	04/18/2026

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