Individual provider · Type 1 NPI

Dominic Tan Wong, GNP-BC

Nurse Practitioner · Panorama City, CA

NPI number 1366472649 Active

Practice location

13652 Cantara St, Balboa Plaza Bldg
Panorama City, CA 91402-5423

Call (818) 832-7287 Map

Fax (818) 250-0061

Mailing address

15971 Thompson Ranch Drive
Santa Clarita, CA 91387

Specialties and licenses

TaxonomyCodeLicense
Registered Nurse 163W00000XRN 587716 (CA)
Registered Nurse 163W00000X587716 (CA)
Gerontology Registered Nurse 163WG0600XNP 15170 (CA)
Gerontology Nurse Practitioner 363LG0600X15170 (CA)
Nurse Practitioner Primary 363L00000X15170 (CA)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1366472649

Dominic Tan Wong, GNP-BC's National Provider Identifier is 1366472649, issued on Jul 3, 2006. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Panorama City, CA. The record was last updated on Feb 16, 2023.