Tammy Wan, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A119071 Issued in CA

Practice address

200 UCLA Medical PLZ
Suite 420
Los Angeles, CA 90095-8344

Phone

(310) 206-4083

Fax

(310) 206-3551

NPI assigned

Nov 10, 2010

Last updated

Nov 29, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

Internal MedicineAlso: Nephrology

Education

University of California, Davis School of Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fresenius Medical Care of South Bay Dialysis facility, Harbor City, CA, CCN 552532
• Kaiser Foundation Hospital - South Bay Hospital, Harbor City, CA, CCN 050411

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment Care Compare group NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Harbor City, CA
  • NPI 1598797011
  NPD
• UCLA Medical Group

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1043427248
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bio-Medical Applications of California, Inc.

  dba Fresenius Medical Care of South Bay

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Harbor City, CA
  • NPI 1609988401

  Dialysis facility

  Care Compare affiliation Name & address match
• Kaiser Foundation Hospitals

  dba Kaiser Foundation Hospital - South Bay

  • General Acute Care Hospital
  • Harbor City, CA
  • NPI 1336294040
  Care Compare affiliation

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

{
    "created_epoch": "1289347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1205137981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 UCLA MEDICAL PLZ",
            "address_2": "SUITE 420",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900958344",
            "telephone_number": "310-206-4083",
            "fax_number": "310-206-3551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 UCLA MEDICAL PLZ",
            "address_2": "SUITE 420",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900958344",
            "telephone_number": "310-206-4083",
            "fax_number": "310-206-3551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAN",
        "first_name": "TAMMY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-10",
        "last_updated": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A119071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "25825 Vermont Ave",
            "city": "Harbor City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "907103518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Patrice Walz
• Sydney Walz
• Nancy Njeri Wambaa
• Lijun Wan, MD
• Ruihan Wan
• Jonathan Wanagat, MD PHD
• Wand Touch Corp
• Karen Wandell
• Anica Maria Wandler, PHD
• Aaron Wang

• Internal Medicine Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.