Individual provider Active NPI

Richard Tang-Wai, MDCM, FRCPC

  • Epilepsy Physician
  • Loma Linda, CA
National Provider Identifier
1124470448
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Epilepsy PhysicianTaxonomy code 2084E0001X
License
C143221 Issued in CA
Practice address
11175 Campus Street
Coleman Pavillion, RM A1120
Loma Linda, CA 92354
Phone
(909) 558-8242
NPI assigned
Jul 11, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Epilepsy Physician 2084E0001X C143221 CA Primary

Addresses

Primary practice location

11175 Campus Street
Coleman Pavillion, RM A1120
Loma Linda, CA 92354

Mailing address

11175 Campus Street
Coleman Pavillion, RM A1120
Loma Linda, CA 92354

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
I20180122002452 CA Practitioner - EpileptologistsPractitioner - NeurologyPractitioner - Pediatric Medicine 2466711312 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C143221CAMDEpilepsy Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm Clinic/Center Current Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Sep 18, 2021 Accepting new patients
Faculty Physicians and Surgeons of Llusm Clinic/Center Current Accepting new patients
Loma Linda University Medical Center Past Accepting new patients
Faculty Physicians and Surgeons of Llusm Past Accepting new patients
Loma Linda University Children'S Hospital Children Past Accepting new patients
Pediatric Physician Services, Inc. Clinic/Center Past Accepting new patients

Locations

81 Highland Springs Ave
Ste 103
Beaumont, CA 92223
Phone (909) 558-2830

11370 Anderson St
Ste 2600
Loma Linda, CA 92354
Phone (909) 558-2890

11370 Anderson St
Ste 1800
Loma Linda, CA 92354
Phone (909) 558-2154

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

Interoperability endpoints

  • Direct secure messaging: rtangwai1388537@direct.hopkinsmedicine.org
  • Direct secure messaging: rtangwai143244@direct.llu.edu

Organizations & group practices 7

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": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1124470448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11175 CAMPUS STREET",
            "address_2": "COLEMAN PAVILLION, RM A1120",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "92354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11175 CAMPUS STREET",
            "address_2": "COLEMAN PAVILLION, RM A1120",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "92354",
            "telephone_number": "909-558-8242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANG-WAI",
        "first_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "MDCM, FRCPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-11",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084E0001X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Epilepsy",
            "state": "CA",
            "license": "C143221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.