Wendy Chan, DPT, LAC, DIPL OM

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

19435 Issued in CA

Practice address

4820 Lincoln Blvd
Marina del Rey, CA 90292-6917

Phone

(310) 392-7889

NPI assigned

Mar 22, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Expanse Wellness Acupuncture and Physical Therapy

  • Acupuncturist
  • Marina del Rey, CA
  • NPI 1588428262
  NPD Authorized official
• Expanse Acupuncture & Physical Therapy Wellness

  • Acupuncturist
  • Brooklyn, NY
  • NPI 1477121499
  NPD (past) Authorized official

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

{
    "created_epoch": "1300752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1285933804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13906 FIJI WAY APT 352",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926934",
            "telephone_number": "818-373-9014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4820 LINCOLN BLVD",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926917",
            "telephone_number": "310-392-7889"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "349 Richmond St",
            "address_purpose": "LOCATION",
            "city": "El Segundo",
            "state": "CA",
            "postal_code": "902453729",
            "country_code": "US",
            "telephone_number": "646-926-2848",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13906 Fiji Way Apt 352",
            "address_purpose": "LOCATION",
            "city": "Marina Del Rey",
            "state": "CA",
            "postal_code": "902926934",
            "country_code": "US",
            "telephone_number": "818-373-9014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAN",
        "first_name": "WENDY",
        "credential": "DPT, LAC, DIPL OM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-22",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "006473",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "0335411",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "37626",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "19435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cedars-Sinai Medical Care Foundation
• Geraldine Cedeno
• Supreet Kaur Chahal, MD
• Shawn N Chaikin, MD
• Phoebe Chakshuvej, FNP
• David Chang, M.D.
• Kevin Wesley Chang
• Charles W Crook Psychologist Inc
• Jasmine Charles
• Arti H Chawla, M.D.

• All providers in Marina del Rey, CA
• Acupuncturist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2024; 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.