Aegis Psychiatry a Professional Corporation

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

AEGIS PSYCHIATRY A PROFESSIONAL CORPORATION

Doing business as

Aegis Psychiatry

Practice address

4225 Executive SQ Ste 600
La Jolla, CA 92037-1484

Phone

(858) 866-8444

NPI assigned

Mar 4, 2020

Last updated

Mar 23, 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

Ryan Wang, MD

Title

Owner

Phone

(858) 866-8444

Specialties & licenses 1

Addresses

Other names 1

• Aegis Psychiatry Doing business as

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

{
    "created_epoch": "1583280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584921600000",
    "number": "1073148680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1770",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919441770",
            "telephone_number": "858-866-8444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4225 EXECUTIVE SQ STE 600",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371484",
            "telephone_number": "858-866-8444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AEGIS PSYCHIATRY A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-04",
        "last_updated": "2020-03-23",
        "certification_date": "2020-03-23",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "858-866-8444",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aegis Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Psychiatry Physician in La Jolla, CA
• Providers in La Jolla, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 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.