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

Mr. Dominic Tan Wong, GNP-BC

Individual provider Registered Nurse · NPI 1366472649

Mr. Dominic Tan Wong, GNP-BC is a Nurse Practitioner in Panorama City, California. Qualified in 2004, 22 years ago. Practices with Meticulous Health Care PC, a 6-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
22
Licensed in
CA
In the registry since
2006
Specialties on file
5

Practice location Address checks out

13652 Cantara St Balboa Plz Bldg
Panorama City, CA 91402-5423
Phone: (818) 832-7287
Fax: (818) 250-0061
Show map & directions

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

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 15170 (CA)
Registered Nurse Taxonomy 163W00000X · Licence RN 587716 (CA)
Registered Nurse Taxonomy 163W00000X · Licence 587716 (CA)
Gerontology Registered Nurse Taxonomy 163WG0600X · Licence NP 15170 (CA)
Gerontology Nurse Practitioner Taxonomy 363LG0600X · Licence 15170 (CA)

Record details

NPI number1366472649
Entity typeIndividual (Type 1)
GenderMale
Credentials GNP-BC
Sole proprietorNo
NPI enumeratedJuly 3, 2006
Last updated in NPPESFebruary 16, 2023
Certification dateFebruary 16, 2023

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Meticulous Health Care Pc — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Panorama City