Theresa Ihsin Wang, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

13983 Issued in HI

Practice address

75-5751 Kuakini Hwy
Suite 101a
Kailua Kona, HI 96740-1752

Phone

(808) 326-5629

NPI assigned

Sep 29, 2005

Last updated

Apr 8, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• West Hawaii Community Health Center, Inc.

  dba Hawaii Island Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Pahoa, HI
  • NPI 1861376907
  NPD (past)
• West Hawaii Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Kailua Kona, HI
  • NPI 1952335630
  NPD (past)

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207612800000",
    "number": "1467449173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75-5751 KUAKINI HWY",
            "address_2": "SUITE 101A",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967401752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75-5751 KUAKINI HWY",
            "address_2": "SUITE 101A",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967401752",
            "telephone_number": "808-326-5629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "THERESA",
        "middle_name": "IHSIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-29",
        "last_updated": "2008-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "38667",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "HI",
            "license": "13983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walmart Inc. (Walmart Pharmacy 10-2321)
• Walmart, Inc. (Walmart pharmacy 10-3164)
• Tina Walter
• Allan Veh Tuc Wang, MD, PHD
• Sophia J Wang, PHD
• Walter J Wang, MD
• Cristina Maria Ward
• Michael Warnecke, BSN, RN
• Mary Katherine Warren, M.D.
• Jamal Fulani Wasan, PH.D

• Family Medicine Physician in Kailua Kona, HI
• Providers in Kailua Kona, HI by specialty
• Family Medicine Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2008; 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.