MEDICARE: MISS IRENE SHUK WONG N.P.

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	363L00000X	Nurse Practitioner	12816	CA

General Provider Information

NPI Number	:	1366516205
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS IRENE SHUK WONG N.P.

Provider Business Mailing Address
First Line	:	12900 PARK PLAZA DR STE 150
Second Line	:
City	:	CERRITOS
State	:	CA
Zip	:	90703-9329
Country	:	US
Telephone Number	:	562-622-2800
Fax Number	:

Provider Business Practice Location Address
First Line	:	4855 ATHERTON AVE
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95130
Country	:	US
Telephone Number	:	888-357-3058
Fax Number	:

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

Provider Enumeration Date	:	11/20/2006
Last Update Date	:	08/30/2019

Similar Medicare Providers

1881914000 — GRUPO MEDICO POLICLINICA SAN PEDRO MEDICARE ADVANTAGE
Practice Location Address:

211 CALLE MORSE
ARROYO, PR
00714-2350

Practice Phone: 787-839-3980
Practice Fax: 787-271-2515

1487691903 — LUCKY STORES II LLC
Practice Location Address:

200 EL PASEO DE SARATOGA
SAN JOSE, CA
95130-1616

Practice Phone: 408-370-1205
Practice Fax: 408-370-1397

1255417135 — DR. MARK E. VENES D.C.
Practice Location Address:

1680 DUVALL DR
SAN JOSE, CA
95130-1717

Practice Phone: 408-252-4730
Practice Fax:

1235295437 — DR. HIROKO MORI JOHNSTONE D.C.
Practice Location Address:

4950 HAMILTON AVE , SUITE 108
SAN JOSE, CA
95130-1750

Practice Phone: 408-871-1111
Practice Fax: 408-871-0881

1316092802 — DR. SAYED JOVKAR M.D.
Practice Location Address:

4855 ATHERTON AVE STE 101
SAN JOSE, CA
95130-1026

Practice Phone: 408-985-2020
Practice Fax: 408-356-9333

1912045840 — DR. SCOTT WADDELL D.C.
Practice Location Address:

4855 ATHERTON AVE STE 204
SAN JOSE, CA
95130-1026

Practice Phone: 408-871-9355
Practice Fax: 408-871-8511

Directions to “ MISS IRENE SHUK WONG N.P.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.