Individual provider Active NPI

Minchen Wang, L.AC., PH.D

  • Acupuncturist
  • San Diego, CA
National Provider Identifier
1417944893
Registry record updated Nov 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC6456 Issued in CA
Practice address
3023 Bunker Hill St
Suite 206
San Diego, CA 92109-5706
Phone
(858) 688-7294
Fax
(858) 746-4212
NPI assigned
Sep 30, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC6456 CA Primary

Addresses

Primary practice location

3023 Bunker Hill St
Suite 206
San Diego, CA 92109-5706

Mailing address

3023 Bunker Hill St
Suite 206
San Diego, CA 92109-5706
Phone (858) 688-7294

Other identifiers 1

IdentifierTypeStateIssuer
AC0064560MedicaidCA

Other names 1

  • Dr. Vince Wang Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
AC6456CAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480032000000",
    "number": "1417944893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3023 BUNKER HILL ST",
            "address_2": "SUITE 206",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921095706",
            "telephone_number": "858-688-7294",
            "fax_number": "858-746-4212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3023 BUNKER HILL ST",
            "address_2": "SUITE 206",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921095706",
            "telephone_number": "858-688-7294",
            "fax_number": "858-746-4212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "MINCHEN",
        "name_prefix": "Dr.",
        "credential": "L.AC., PH.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2016-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC6456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AC0064560",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VINCE",
            "last_name": "WANG",
            "prefix": "DR.",
            "credential": "PH.D. L.AC.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 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.