Active NPI
Mark Sapaen Watan, L.AC.
- Acupuncturist
- San Mateo, CA
National Provider Identifier
1427290576
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC12090
- Practice address
- 205 E 3Rd Ave
Suite 410
San Mateo, CA 94401-4051 - Phone
- (415) 713-3571
- NPI assigned
- Apr 2, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | AC12090 | CA | Primary |
Addresses
Primary practice location
205 E 3Rd Ave
Suite 410
San Mateo, CA 94401-4051
Mailing address
38780 Tyson LN
Unit 112C
Fremont, CA 94536-4079
Phone (415) 713-3571
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AC12090 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1238630400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1238630400000",
"number": "1427290576",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38780 TYSON LN",
"address_2": "UNIT 112C",
"city": "FREMONT",
"state": "CA",
"postal_code": "945364079",
"telephone_number": "415-713-3571"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 E 3RD AVE",
"address_2": "SUITE 410",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944014051",
"telephone_number": "415-713-3571"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATAN",
"first_name": "MARK",
"middle_name": "SAPAEN",
"name_prefix": "Mr.",
"credential": "L.AC.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-04-02",
"last_updated": "2009-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "AC12090",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Mateo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.