Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Axel Antonio Wong

Individual provider Independent Duty Corpsman · NPI 1417639642

Axel Antonio Wong is an Independent Duty Corpsman in San Diego, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2023

Practice location Address checks out

34101 Farenholt Ave Bldg 14
San Diego, CA 92134-7000
Phone: (619) 532-7968
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Independent Duty Corpsman (primary) Taxonomy 1710I1002X (CA)

Record details

NPI number1417639642
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedAugust 7, 2023
Last updated in NPPESAugust 7, 2023
Certification dateAugust 7, 2023

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