Individual provider Active NPI

Aki Yen Chang Wen, D.O

  • Family Medicine Physician
  • San Diego, CA
National Provider Identifier
1205126505
Registry record updated Mar 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A12555 Issued in CA
Practice address
6386 Alvarado CT Ste 310
San Diego, CA 92120-4908
Phone
(619) 713-7899
NPI assigned
Apr 8, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A12555 CA Primary

Addresses

Primary practice location

6386 Alvarado CT Ste 310
San Diego, CA 92120-4908

Mailing address

10170 Sorrento Valley Rd
San Diego, CA 92121-1604
Phone (858) 784-5888

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
I20140930001807 CA Practitioner - Family Practice 3375763121 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1136 D Ave
National City, CA 91950-3412
Phone (619) 662-4100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12555CAMDMarriage & Family Therapist
20A12555CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centro de Salud de la Comunidad de San Ysidro, Inc. CurrentSince Sep 5, 2014 Accepting new patients
Centro de Salud de la Comunidad de San Ysidro Inc CurrentSince Sep 5, 2014 Accepting new patients
Centro de Salud de la Comunidad de San Ysidro, Inc. Current Accepting new patients
Centro de Salud de la Comunidad de San Ysidro, Inc. Past Accepting new patients
Scripps Health Past Accepting new patients

Locations

678 Third Ave
Chula Vista, CA 91910
Phone (619) 205-6349

1637 Third Ave
Ste B
Chula Vista, CA 91911
Phone (619) 425-1780

1136 D Ave
National City, CA 91950
Phone (619) 336-2300

1601 Precision Park Ln
San Ysidro, CA 92173
Phone (619) 205-4585

4004 Beyer Blvd
San Ysidro, CA 92173
Phone (619) 428-1330

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

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": "1302220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426550400000",
    "number": "1205126505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10170 SORRENTO VALLEY RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211604",
            "telephone_number": "858-784-5888",
            "fax_number": "858-784-5960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6386 ALVARADO CT STE 310",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921204908",
            "telephone_number": "619-713-7899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEN",
        "first_name": "AKI",
        "middle_name": "YEN CHANG",
        "credential": "D.O",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-08",
        "last_updated": "2015-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A12555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.