James T Wang MD Inc

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

G79462 Issued in CA

Legal business name

JAMES T WANG MD INC

Practice address

29833 Santa Margarita Pkwy
Suite 100
Rancho Santa Margarita, CA 92688-3619

Phone

(949) 888-9288

Fax

(949) 888-8918

NPI assigned

Jun 7, 2007

Organization subpart

No

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

Authorized official

Name

James T Wang, MDNPI 1013091396

Title

Owner

Phone

(949) 888-9288

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• James T Wang, M.D.

  • Dermatology Physician
  • Rancho Santa Margarita, CA
  • NPI 1013091396
  Medicare reassignment NPD Authorized official
• Caitlin Grace Garrison, PA-C

  • Physician Assistant
  • Huntington Beach, CA
  • NPI 1710237011
  NPD (past)

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616371200000",
    "number": "1366645145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29833 SANTA MARGARITA PKWY",
            "address_2": "SUITE 100",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926883619",
            "telephone_number": "949-888-9288",
            "fax_number": "949-888-8918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29833 SANTA MARGARITA PKWY",
            "address_2": "SUITE 100",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926883619",
            "telephone_number": "949-888-9288",
            "fax_number": "949-888-8918"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17822 Beach Blvd Ste 468",
            "address_purpose": "LOCATION",
            "city": "Huntington Beach",
            "state": "CA",
            "postal_code": "926477520",
            "country_code": "US",
            "telephone_number": "714-841-8818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JAMES T WANG MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-07",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-888-9288",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G79462",
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "05D1021032",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA CORPORATION NUMBER",
            "identifier": "C2548617",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Natalie James, LAC
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• Jeanne Nguyen, DDS, Inc.
• Jeff Wong, DDS, Inc
• Katie Lynne Jeko

• Dermatology Physician in Rancho Santa Margarita, CA
• Providers in Rancho Santa Margarita, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.