Individual provider Active NPI

Wei Fan, MD

  • Hospitalist Physician
  • Stockton, CA
National Provider Identifier
1053499863
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
A67123 Issued in CA
Practice address
7373 West LN
Stockton, CA 95210-3377
Phone
(209) 476-2000
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X A67123 CA Primary

Addresses

Primary practice location

7373 West LN
Stockton, CA 95210-3377

Mailing address

1800 Harrison St FL 7
Oakland, CA 94612-3429
Phone (510) 625-6262

Other identifiers 1

IdentifierTypeStateIssuer
00A671230MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101119001209 CA Practitioner - Internal MedicinePractitioner - Hospitalist 4284820903 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A67123CAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lodi Memorial Hospital Association Inc CurrentSince Aug 1, 2021 Accepting new patients
Hospitalist Medicine Physicians of California, Inc Hospitalist CurrentSince Jul 1, 2016 Accepting new patients
Lodi Memorial Hospital Association, Inc Current Accepting new patients
Inpatient Specialists of California, PC Hospitalist CurrentSince Feb 1, 2016 Accepting new patients
Providence Medical Foundation Past Accepting new patients

Locations

18300 US Highway 18
Apple Valley, CA 92307
Phone (760) 424-2311

2615 Chester Ave
Bakersfield, CA 93301
Phone (661) 381-7545

1255 Travis Blvd
Fairfield, CA 94533
Phone (707) 425-0623

2000 Mowry Ave
Fremont, CA 94538
Phone (510) 793-6653

975 S Fairmont Ave
Lodi, CA 95240
Phone (209) 339-7575

1441 Constitution Blvd
Salinas, CA 93906
Phone (831) 261-8090

13855 E 14th St
San Leandro, CA 94578
Phone (510) 357-6500

347 Andrieux St
Sonoma, CA 95476
Phone (707) 935-5000

1000 Greenley Rd
Sonora, CA 95370
Phone (209) 263-0803

525 W Acacia St
Stockton, CA 95203
Phone (209) 944-5410

1800 N California St
Stockton, CA 95204
Phone (209) 467-6400

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053499863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 HARRISON ST FL 7",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946123429",
            "telephone_number": "510-625-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7373 WEST LN",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952103377",
            "telephone_number": "209-476-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAN",
        "first_name": "WEI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A67123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A671230",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.