Wilson Wang, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

242920 Issued in NY

Practice address

4000 Civic Center Dr Ste 206
San Rafael, CA 94903-5233

Phone

(415) 925-8070

NPI assigned

Oct 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, NJ2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989

Interoperability endpoints

• Direct secure messaging: wilson.wang@direct.hobokenumc.md

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.

• New York University

  • Cardiovascular Disease Physician
  • Boynton Beach, FL
  • NPI 1285826438

  NY, Pediatrics

  Medicare reassignment NPD
• Physician Affiliate Group of New York PC

  • Registered Dietitian
  • New York, NY
  • NPI 1013375526
  Medicare reassignment NPD
• Valley Physician Services PC

  • Internal Medicine Physician
  • Paramus, NJ
  • NPI 1467815928
  Medicare reassignment NPD
• Humc Opco LLC

  • General Acute Care Hospital
  • Hoboken, NJ
  • NPI 1043475668
  NPD
• New York University

  • Physical Medicine & Rehabilitation Physician
  • Boynton Beach, FL
  • NPI 1104787613
  NPD
• California Em-I Medical Services

  • Emergency Medicine Physician
  • San Francisco, CA
  • NPI 1649229600
  NPD (past)
• The Valley Hospital Inc.

  • General Acute Care Hospital
  • Paramus, NJ
  • NPI 1013912633
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786060800000",
    "number": "1073608543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 18TH ST NW APT 601",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200092516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 CIVIC CENTER DR STE 206",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949035233",
            "telephone_number": "415-925-8070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3555 Cesar Chavez Street",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "94110",
            "country_code": "US",
            "telephone_number": "415-647-8600",
            "fax_number": "415-641-6823",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANG",
        "first_name": "WILSON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2026-08-07",
        "certification_date": "2026-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A75880",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "242920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samuel J. Walters, MD
• Zoe Walton, L.AC
• Lai Ping Atalanta Wan, RN, CNS
• Marissa Wang, DMD
• Samuel Wang, L.AC.
• Tashi Wangdu, RPH
• Anne M. Wara, MD
• Karen Ward
• Anne J. Wardell, R.PH.
• Georgiana S. Wardle, MFT

• Pediatrics Physician in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.