Individual provider Active NPI

Dejun Wang, M.D.

  • Internal Medicine Physician
  • Rowland Heights, CA
National Provider Identifier
1275559288
Registry record updated Nov 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A71575 Issued in CA
Practice address
19115 Colima Rd Unit 104
Rowland Heights, CA 91748-3074
Phone
(626) 810-2983
Fax
(626) 810-5741
NPI assigned
Jul 14, 2006
Last updated
Nov 6, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A71575 CA Primary

Addresses

Primary practice location

19115 Colima Rd Unit 104
Rowland Heights, CA 91748-3074

Mailing address

19115 Colima Rd Unit 104
Rowland Heights, CA 91748-3074
Phone (626) 810-2983

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
I20040331001224 CA Practitioner - Internal Medicine 4789676651 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

19115 Colima Rd
Unit 104
Rowland Heights, CA 91748-3074
Phone (626) 810-2983

Hospital & facility affiliations

National Provider Directory

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

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ivy Hospice Care IncUpland, CA, CCN 751688 Hospice Contracted Managing Employee (100%) Nov 6, 2014

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 1

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572998400000",
    "number": "1275559288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19115 COLIMA RD UNIT 104",
            "city": "ROWLAND HEIGHTS",
            "state": "CA",
            "postal_code": "917483074",
            "telephone_number": "626-810-2983",
            "fax_number": "626-810-5741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19115 COLIMA RD UNIT 104",
            "city": "ROWLAND HEIGHTS",
            "state": "CA",
            "postal_code": "917483074",
            "telephone_number": "626-810-2983",
            "fax_number": "626-810-5741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "DEJUN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2019-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A71575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rowland Heights, CA

Sources for this page

Verify at the official NPI Registry.