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

Kam Chak Wong, PA

Individual provider Physician Assistant · NPI 1255623542

Kam Chak Wong, PA is a Physician Assistant in Pomona, California. Qualified in 2009, 17 years ago. Practices with Lakeside Medical Organization a Medical Group Inc, a 65-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
17
Licensed in
CA
In the registry since
2011
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

260 E Holt Ave
Pomona, CA 91767-5426
Phone: (909) 629-8088
Fax: (818) 587-2493
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA21541 (CA)

Record details

NPI number1255623542
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorYes
NPI enumeratedMay 5, 2011
Last updated in NPPESMay 5, 2011

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Lakeside Medical Organization A Medical Group Inc — 65 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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