Provider Demographics
NPI:1306166343
Name:SZETO-WONG, CYRUS CL (MD)
Entity type:Individual
Prefix:DR
First Name:CYRUS
Middle Name:CL
Last Name:SZETO-WONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:CYRUS
Other - Middle Name:CL
Other - Last Name:WONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:751 S BASCOM AVE STE 340
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-2699
Mailing Address - Country:US
Mailing Address - Phone:408-793-2530
Mailing Address - Fax:
Practice Address - Street 1:751 S BASCOM AVE STE 340
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-2699
Practice Address - Country:US
Practice Address - Phone:408-793-2530
Practice Address - Fax:808-744-4521
Is Sole Proprietor?:No
Enumeration Date:2010-06-01
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-18416207RC0000X, 207RC0001X
CAA126096207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
H107583Medicare PIN