Provider Demographics
NPI:1750340964
Name:WONG, KIN CHIU (MD)
Entity type:Individual
Prefix:DR
First Name:KIN
Middle Name:CHIU
Last Name:WONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 445
Mailing Address - Street 2:
Mailing Address - City:DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92014-0445
Mailing Address - Country:US
Mailing Address - Phone:619-448-2866
Mailing Address - Fax:619-448-5714
Practice Address - Street 1:10201 MISSION GORGE RD
Practice Address - Street 2:SUITE K
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92071-3026
Practice Address - Country:US
Practice Address - Phone:619-448-2866
Practice Address - Fax:619-448-5714
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA40726207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine