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

Brian Wong

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1124474960

Brian Wong is a Student in an Organized Health Care Education/Training Program in Eagle, Idaho. Works from 3 locations. Licensed in Idaho.

Licensed in
ID
In the registry since
2016
Specialties on file
2
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

3217 W Bavaria St
Eagle, ID 83616-5171
Phone: (208) 302-6200
Fax: (208) 302-6245
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Additional practice locations (2)

  • 11234 Anderson St, Loma Linda, CA 92354-2804 — (909) 558-4174
  • 3653 N Locust Grove Rd, Meridian, ID 83646-5924 — (208) 338-6437

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence M-14689 (ID)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1124474960
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMay 11, 2016
Last updated in NPPESJune 2, 2025
Certification dateJune 2, 2025
Mailing addressPo Box 190930, Boise, ID 83719-0930

Other providers in Eagle