Individual provider Active NPI

Hannah Claire Wangberg

  • Allergy & Immunology Physician
  • San Diego, CA
National Provider Identifier
1306233663
Registry record updated Sep 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
A145713 Issued in CA
Practice address
200 W Arbor Dr
MC 8425
San Diego, CA 92103-8425
Phone
(619) 471-0434
NPI assigned
Apr 23, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X A145713 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

200 W Arbor Dr
MC 8425
San Diego, CA 92103-8425

Mailing address

10790 Rancho Bernardo Rd
San Diego, CA 92127-5705
Phone (858) 764-9010

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
I20210922003689 CA Practitioner - Allergy/Immunology 6103223805 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
University of Minnesota Medical School, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Scripps HealthGroup PAC ID 9234033853, 1,450 clinicians

Practice addresses (Care Compare)

3811 Valley Centre Dr
San Diego, CA 92130-3318
Phone (858) 764-3000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A145713CAMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Allergy & Immunology CurrentSince Oct 18, 2021 Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health CurrentSince Oct 18, 2021 Accepting new patients
Scripps Clinic Medical Group Past Accepting new patients

Locations

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

File 54433
Los Angeles, CA 90074
Phone (858) 784-5645

15004 Innovation Dr
San Diego, CA 92128
Phone (858) 487-1800

3811 Valley Centre Dr
San Diego, CA 92130
Phone (858) 554-8645

10790 Rancho Bernardo Rd
San Diego, CA 92127
Phone (858) 554-2626

Interoperability endpoints

  • Direct secure messaging: hwangberg79337@scrippshlth.medalliesdirect.net

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1429747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1306233663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10790 RANCHO BERNARDO RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275705",
            "telephone_number": "858-764-9010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "address_2": "MC 8425",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921038425",
            "telephone_number": "619-471-0434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANGBERG",
        "first_name": "HANNAH",
        "middle_name": "CLAIRE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-23",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "CA",
            "license": "A145713",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.