Individual provider · Type 1 NPI

Brian Wong

Pediatrics Physician · Eagle, ID

NPI number 1124474960 Active

Practice location

3217 W Bavaria St
Eagle, ID 83616-5171

Call (208) 302-6200 Map

Fax (208) 302-6245

Mailing address

PO Box 190930
Boise, ID 83719-0930

Other practice locations

11234 Anderson St, Gme Office Westerly Suite C, Loma Linda, CA 92354-2804 · (909) 558-4174
3653 N Locust Grove Rd, Meridian, ID 83646-5924 · (208) 338-6437

Specialties and licenses

Taxonomy	Code	License
Student in an Organized Health Care Education/Training Program	390200000X	None listed
Pediatrics Physician Primary	208000000X	M-14689 (ID)

Pediatrics Physician: A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on de…

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About NPI 1124474960

Brian Wong's National Provider Identifier is 1124474960, issued on May 11, 2016. The primary taxonomy on file is Pediatrics Physician (208000000X), and the practice location is in Eagle, ID. The record was last updated on Jun 2, 2025.