Provider Demographics
NPI:1902935547
Name:WONG, MARGARITA MARIA (PA)
Entity Type:Individual
Prefix:
First Name:MARGARITA
Middle Name:MARIA
Last Name:WONG
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:1345 PLAZA COURT NORTH
Mailing Address - Street 2:#1A
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-2832
Mailing Address - Country:US
Mailing Address - Phone:303-665-3036
Mailing Address - Fax:720-206-0434
Practice Address - Street 1:8990 N. WASHINGTON
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-4537
Practice Address - Country:US
Practice Address - Phone:720-929-1655
Practice Address - Fax:720-206-0434
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO2261363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO29255252Medicaid
CO29255252Medicaid
MW1463063OtherDEA