Active NPI
Atlantic Healthcare
- Family Medicine Physician
- San Gabriel, CA
National Provider Identifier
1306069109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- A72461A
- Legal business name
- ATLANTIC HEALTHCARE
- Practice address
- 901 E Valley Blvd
San Gabriel, CA 91776-3608 - Phone
- (626) 308-0805
- Fax
- (626) 280-1616
- NPI assigned
- Apr 10, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Philip Z Wang, L. AC.
- Title
- President
- Phone
- (626) 308-0805
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | AC8801 | CA | |
| Family Medicine Physician | 207Q00000X | A72461A | CA | Primary |
| General Practice Physician | 208D00000X | A72461 | CA |
Addresses
Primary practice location
901 E Valley Blvd
San Gabriel, CA 91776-3608
Mailing address
901 E Valley Blvd
San Gabriel, CA 91776-3608
Phone (626) 308-0805
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176163200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1457913600000",
"number": "1306069109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "901 E VALLEY BLVD",
"city": "SAN GABRIEL",
"state": "CA",
"postal_code": "917763608",
"telephone_number": "626-308-0805",
"fax_number": "626-280-1616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 E VALLEY BLVD",
"city": "SAN GABRIEL",
"state": "CA",
"postal_code": "917763608",
"telephone_number": "626-308-0805",
"fax_number": "626-280-1616"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ATLANTIC HEALTHCARE",
"organizational_subpart": "NO",
"enumeration_date": "2007-04-10",
"last_updated": "2016-03-14",
"status": "A",
"authorized_official_last_name": "WANG",
"authorized_official_first_name": "PHILIP",
"authorized_official_middle_name": "Z",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "626-308-0805",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "L. AC."
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Acupuncturist",
"state": "CA",
"license": "AC8801",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "CA",
"license": "A72461A",
"primary": true
},
{
"code": "208D00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "General Practice",
"state": "CA",
"license": "A72461",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Gabriel, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.