Active NPI
Dan Wang
- Massage Therapist
- Pasadena, CA
National Provider Identifier
1275204125
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 69628
- Practice address
- 80 N Lake Ave Ste 103
Pasadena, CA 91101-5629 - Phone
- (626) 466-5364
- NPI assigned
- Sep 21, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 69628 | CA | Primary |
Addresses
Primary practice location
80 N Lake Ave Ste 103
Pasadena, CA 91101-5629
Mailing address
80 N Lake Ave Ste 103
Pasadena, CA 91101-5629
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | Pasadena |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 69628 | CA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632182400000",
"number": "1275204125",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "80 N LAKE AVE STE 103",
"city": "PASADENA",
"state": "CA",
"postal_code": "911015629"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "80 N LAKE AVE STE 103",
"city": "PASADENA",
"state": "CA",
"postal_code": "911015629",
"telephone_number": "626-466-5364"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANG",
"first_name": "DAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-09-21",
"last_updated": "2021-09-21",
"certification_date": "2021-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CA",
"license": "69628",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "Pasadena",
"affiliation": "N",
"address_1": "80 N Lake Ave Ste 103",
"city": "Pasadena",
"state": "CA",
"country_code": "US",
"postal_code": "911015629",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.