NPIMap

Organization Active NPI

Wellness Express Clinic

  • General Practice Physician
  • San Ramon, CA
National Provider Identifier
1366478679
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
WELLNESS EXPRESS CLINIC
Practice address
111 Deerwood PL
Suite 200
San Ramon, CA 94583-4409
Phone
(925) 855-3222
NPI assigned
Jun 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Wesley Paul Chan, M.D.
Title
President
Phone
(925) 855-3222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X CA Primary

Addresses

Primary practice location

111 Deerwood PL
Suite 200
San Ramon, CA 94583-4409

Mailing address

111 Deerwood PL
Suite 200
San Ramon, CA 94583-4409
Phone (925) 855-3222

National Provider Directory

National Provider Directory
Tax ID family
Wellness Express Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366478679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 DEERWOOD PL",
            "address_2": "SUITE 200",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945834409",
            "telephone_number": "925-855-3222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 DEERWOOD PL",
            "address_2": "SUITE 200",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945834409",
            "telephone_number": "925-855-3222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS EXPRESS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "WESLEY",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "925-855-3222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Ramon, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.