Chung Nan Wang, M.D., Inc.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

A31187 Issued in CA

Legal business name

CHUNG NAN WANG, M.D., INC.

Practice address

147 N Brent St
Ventura, CA 93003-2809

Phone

(805) 652-5011

NPI assigned

Jul 18, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Chung Nan Wang, M.D.

Title

Owner

Phone

(310) 471-5852

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1033137617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11999 SAN VICENTE BLVD",
            "address_2": "#440",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900495131",
            "telephone_number": "310-471-5852",
            "fax_number": "310-471-3958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 N BRENT ST",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930032809",
            "telephone_number": "805-652-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHUNG NAN WANG, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "CHUNG NAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-471-5852",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A31187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0064530",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Derrick Chu, DO
• Mark James Escalona Chua
• Grant Michael Chudik, DO
• Eric Chun, M.D.
• Chung Nan Wang MD Inc
• Megan E Chynoweth, PHARM.D.
• Mahealani Ciabattoni
• Zoriesha Cie, M.D.
• Jennifer Cimarusti, FNP
• Dana Marie Cinnamon, MS

• Anesthesiology Physician in Ventura, CA
• Providers in Ventura, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.