Michael James Wade, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A59820 Issued in CA

Practice address

791 Orchard St
Coachella, CA 92236-1730

Phone

(760) 398-0128

Fax

(760) 398-0317

NPI assigned

Jul 8, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Central Occupational Medicine Providers Ontario Inc

  • Occupational Medicine Clinic/Center
  • Riverside, CA
  • NPI 1972861797

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588204800000",
    "number": "1194723668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10603",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922550603",
            "telephone_number": "714-404-7041",
            "fax_number": "760-406-5697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "791 ORCHARD ST",
            "city": "COACHELLA",
            "state": "CA",
            "postal_code": "922361730",
            "telephone_number": "760-398-0128",
            "fax_number": "760-398-0317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2020-04-30",
        "certification_date": "2020-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "CA",
            "license": "20A5982",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A59820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX59820",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marlen Vidal Ayala
• Monica Vidal, M.S
• Village Counseling
• Maricella Villalobos
• Vma Medical Transportation
• Walgreen Co (Walgreens # 11611)
• Walmart Inc. (WalMart Pharmacy 10-2826)
• Devin Camille Wellard
• David Whitley
• Patricia Marie Wooten, PHARM.D

• Family Medicine Physician in Coachella, CA
• Providers in Coachella, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.