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Search › Idaho › 208000000X

Brian Wong

NPI 1124474960 · on the registry since 2016

Practice

Address
3217 W Bavaria St
Eagle, ID 83616
Phone
(208) 302-6200
Fax
(208) 302-6245
Organisation at this address
Oasis Pediatrics
Inferred from a shared address, not stated in the registry.
Clinicians at this address
11

Additional practice sites

  • 11234 Anderson St, Loma Linda, CA
  • 3653 N Locust Grove Rd, Meridian, ID

Registry record

Primary taxonomy
208000000X
208000000X
Also registered as
390200000X
Licence states on file
ID
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2025-06-02

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho