Jay G. Wani, M.D., Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A32304 Issued in CA

Legal business name

JAY G. WANI, M.D., INC.

Practice address

1401 Spanos CT
Suite 102
Modesto, CA 95355-2810

Phone

(209) 525-3113

Fax

(209) 525-3114

NPI assigned

Sep 11, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jay G Wani, M.D.

Title

M.D.

Phone

(209) 525-3113

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189468800000",
    "number": "1215122452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 SPANOS CT",
            "address_2": "SUITE 102",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953552810",
            "telephone_number": "209-525-3113",
            "fax_number": "209-525-3114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 SPANOS CT",
            "address_2": "SUITE 102",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953552810",
            "telephone_number": "209-525-3113",
            "fax_number": "209-525-3114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAY G. WANI, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-11",
        "last_updated": "2007-09-11",
        "status": "A",
        "authorized_official_last_name": "WANI",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "209-525-3113",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A32304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8726716",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Modesto, CA
• Providers in Modesto, 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 Sep 11, 2007; 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.