Individual provider Active NPI

Kuan I Wang, MD

  • Obstetrics & Gynecology Physician
  • Monterey Park, CA
National Provider Identifier
1154471662
Registry record updated Oct 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A53663 Issued in CA
Practice address
600 N Garfield Ave
#309
Monterey Park, CA 91754
Phone
(626) 288-0123
Fax
(626) 288-2892
NPI assigned
Jan 10, 2007
Last updated
Oct 3, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A53663 CA Primary

Addresses

Primary practice location

600 N Garfield Ave
#309
Monterey Park, CA 91754

Mailing address

600 N Garfield Ave
#309
Monterey Park, CA 91754
Phone (626) 288-0123

Other identifiers 2

IdentifierTypeStateIssuer
00A536630MedicaidCA
00A536631MedicaidCA

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
I20110317000172 CA Practitioner - Obstetrics/Gynecology 3072795756 Reassigns benefits to 1 organization
Practice locations: Monterey Park, CA; Arcadia, CA

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
National Medical University, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

600 N Garfield Ave
Suite 309
Monterey Park, CA 91754-1172
Phone (626) 288-0123

624 W Duarte Rd
Suite 206
Arcadia, CA 91007-9264
Phone (626) 447-8123

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A53663CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Medical Center, Inc. Current Accepting new patients
Southern California Medical Center, Inc. CurrentSince Jul 24, 2023 Accepting new patients
Southern California Medical Center, Inc. CurrentSince Jul 24, 2023 Accepting new patients
Stephen K Kwan M D Inc PastSince Dec 1, 2010 Accepting new patients

Locations

12100 Valley Blvd
Ste 109A
El Monte, CA 91732
Phone (626) 575-7500

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412294400000",
    "number": "1154471662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N GARFIELD AVE",
            "address_2": "#309",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "91754",
            "telephone_number": "626-288-0123",
            "fax_number": "626-288-2892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N GARFIELD AVE",
            "address_2": "#309",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "91754",
            "telephone_number": "626-288-0123",
            "fax_number": "626-288-2892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "KUAN I",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2014-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A53663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A536630",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A536631",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey Park, CA

Sources for this page

Verify at the official NPI Registry.