Wilshire District Medical Group

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

A69991 Issued in CA

Legal business name

WILSHIRE DISTRICT MEDICAL GROUP

Practice address

1314 Wilshire Blvd.
Los Angeles, CA 90017-1705

Phone

(213) 384-5132

Fax

(213) 234-4542

NPI assigned

Aug 15, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Simon Jiang, M.D.

Title

Ceo

Phone

(213) 384-5132

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506988800000",
    "number": "1447363692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13521 TELEGRAPH RD STE B",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906053462",
            "telephone_number": "562-946-7571",
            "fax_number": "213-234-4542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 WILSHIRE BLVD.",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171705",
            "telephone_number": "213-384-5132",
            "fax_number": "213-234-4542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSHIRE DISTRICT MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-15",
        "last_updated": "2017-10-03",
        "status": "A",
        "authorized_official_last_name": "JIANG",
        "authorized_official_first_name": "SIMON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "213-384-5132",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A69991",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "A69991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A699910",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wilshire Center for Ambulatory Surgery, Inc.
• Wilshire Center for Cosmetic Surgery, a Professional Corporation
• Wilshire Center for Dermatology, a Professional Corporation
• Wilshire Co Medical Group Inc
• Wilshire Dermatology Medical Group, Inc.
• Wilshire Endoscopy Center LLC
• Wilshire Foot and Ankle, Inc.
• Wilshire Health Services Inc
• Wilshire Healthcare Center LLC
• Wilshire Home Health Inc

• General Practice Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2017; 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.