KRISTIN GRACE WONG PA-C
NPI 1083508055
Physician Assistant in Los Angeles, CA

Active since June 04, 2025
590 N VERMONT AVE, LOS ANGELES, CA 90004(310) 863-8236 Get Directions Write a Review

NPPES record last updated: June 11, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jun 11, 2025, Jun 4, 2025 (2 updates tracked since 2025).

About Kristin Grace Wong Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KRISTIN GRACE WONG PA-C (NPI 1083508055) is an individual physician assistant in Los Angeles, California and active in the NPI registry since June 2025.

NPPES Registry Identity

NPI1083508055
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameKRISTIN GRACE WONGCredential: PA-C
Location Address590 N VERMONT AVELos Angeles, CA 90004-2115
Mailing Address27930 Ridgebrook CtRancho Palos Verdes, CA 90275-3303 · (310) 863-8236
Sole ProprietorYes
Enumeration DateJune 4, 2025
Last NPPES UpdateJune 11, 20252 updates tracked since enumeration
NPPES CertifiedJune 11, 2025
NPI 1083508055 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

590 N VERMONT AVE, Los Angeles, CA 90004

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Chiropractor
590 N VERMONT AVE
LOS ANGELES, CA 90004
Pharmacist
590 N VERMONT AVE
LOS ANGELES, CA 90004
Pharmacist
590 N VERMONT AVE
LOS ANGELES, CA 90004
Pharmacist (Pharmacotherapy)
590 N VERMONT AVE
LOS ANGELES, CA 90004
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
590 N VERMONT AVE
LOS ANGELES, CA 90004
Nurse Practitioner
590 N VERMONT AVE
LOS ANGELES, CA 90004
Physician Assistant
590 N VERMONT AVE
LOS ANGELES, CA 90004
Physician Assistant
590 N VERMONT AVE
LOS ANGELES, CA 90004

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1083508055, enumerated as an "individual" on June 04, 2025.

The provider is located at 590 N VERMONT AVE LOS ANGELES, CA 90004 and the phone number is (310) 863-8236.

Physician Assistant with taxonomy code 363A00000X.