Individual provider Active NPI

Pean-Yuan Wang, M.D.

  • General Practice Physician
  • Artesia, CA
National Provider Identifier
1154417061
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A37759 Issued in CA
Practice address
12225 South St
Suite 105
Artesia, CA 90701-7053
Phone
(562) 402-2993
Fax
(562) 860-1819
NPI assigned
Oct 5, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A37759 CA
General Practice Physician 208D00000X A37759 CA Primary

Addresses

Primary practice location

12225 South St
Suite 105
Artesia, CA 90701-7053

Mailing address

12225 South St
Suite 105
Artesia, CA 90701-7053
Phone (562) 402-2993

Other identifiers 1

IdentifierTypeStateIssuer
00A377591MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1154417061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12225 SOUTH ST",
            "address_2": "SUITE 105",
            "city": "ARTESIA",
            "state": "CA",
            "postal_code": "907017053",
            "telephone_number": "562-402-2993",
            "fax_number": "562-860-1819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12225 SOUTH ST",
            "address_2": "SUITE 105",
            "city": "ARTESIA",
            "state": "CA",
            "postal_code": "907017053",
            "telephone_number": "562-402-2993",
            "fax_number": "562-860-1819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "PEAN-YUAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A37759",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A37759",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A377591",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Artesia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.