NPIMap

Individual provider Active NPI

Lin Wang

  • Nephrology Physician
  • Los Angeles, CA
National Provider Identifier
1366974859
Registry record updated Feb 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
20A18540 Issued in CA
Practice address
1400 S Grand Ave Ste 800
Los Angeles, CA 90015-3048
Phone
(213) 748-1414
NPI assigned
Apr 3, 2017
Last updated
Feb 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 20A18540 CA Primary

Addresses

Primary practice location

1400 S Grand Ave Ste 800
Los Angeles, CA 90015-3048

Mailing address

1400 S Grand Ave Ste 800
Los Angeles, CA 90015-3048
Phone (213) 748-1414

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230315000742 CA Practitioner - NephrologyPractitioner - Internal Medicine 0547531899 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Touro Un College of Osteopathic Medicine, Vallejo, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Premier Nephrology Medical Group IncGroup PAC ID 5193709947, 5 clinicians

Practice addresses (Care Compare)

12021 Wilmington Ave
Suite 1000
Los Angeles, CA 90059-3019
Phone (424) 529-6755

1400 S Grand Ave
Suite 800
Los Angeles, CA 90015-3048
Phone (213) 748-1414

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18540CAMDAcupuncturist
20A18540CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Nephrology Medical Group, Inc. Nephrology CurrentSince Dec 6, 2022 Accepting new patients
Martin Luther King Jr Community Medical Foundation CurrentSince Nov 21, 2023 Accepting new patients
Martin Luther King Jr Community Medical Foundation CurrentSince Nov 21, 2023 Accepting new patients
Dignity Community Care Past Accepting new patients
Martin Luther King, Jr. - Los Angeles (MLK-la) Healthcare Corporation Past Accepting new patients
Good Samaritan Hospital Ca LTD PTP Past Accepting new patients
Pih Health Good Samaritan Hospital Past Accepting new patients
Total Renal Care Inc PastSince May 1, 2025 Accepting new patients

Locations

2215 W Rosecrans Ave
Ste 22
Compton, CA 90222
Phone (424) 529-6755

12021 Wilmington Ave
Ste 1000
Los Angeles, CA 90059
Phone (424) 529-6577

1400 S Grand Ave
Ste 800
Los Angeles, CA 90015
Phone (213) 748-1414

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1491177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1366974859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 S GRAND AVE STE 800",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900153048",
            "telephone_number": "213-748-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S GRAND AVE STE 800",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900153048",
            "telephone_number": "213-748-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "LIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-03",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "20A18540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.