Organization Active NPI

Atlantic Healthcare

  • Family Medicine Physician
  • San Gabriel, CA
National Provider Identifier
1306069109
Registry record updated Mar 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A72461A Issued in CA
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

Updated by the provider on Mar 14, 2016

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)CodeLicenseStatePrimary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X AC8801 CA
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X A72461A CA Primary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 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 Directory

NPI 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.

Verify at the official NPI Registry.