Active NPI
Gavin Wang, L.AC.
- Acupuncturist
- San Gabriel, CA
National Provider Identifier
1487877734
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC9190
- Practice address
- 901 E Valley Blvd
San Gabriel, CA 91776-3608 - Phone
- (626) 280-8856
- NPI assigned
- Apr 11, 2007
- 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 | AC9190 | CA | Primary |
Addresses
Primary practice location
901 E Valley Blvd
San Gabriel, CA 91776-3608
Mailing address
901 E Valley Blvd
San Gabriel, CA 91776-3608
Phone (626) 280-8856
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 |
|---|---|---|---|
| AC9190 | CA | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Galaxy Health Care Inc | Single Specialty | Current | Accepting new patients |
Locations
901 E Valley Blvd
San Gabriel, CA 91776
Phone (626) 280-8856
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1255478400000",
"number": "1487877734",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "901 E VALLEY BLVD",
"city": "SAN GABRIEL",
"state": "CA",
"postal_code": "917763608",
"telephone_number": "626-280-8856"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 E VALLEY BLVD",
"city": "SAN GABRIEL",
"state": "CA",
"postal_code": "917763608",
"telephone_number": "626-280-8856"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANG",
"first_name": "GAVIN",
"credential": "L.AC.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-11",
"last_updated": "2009-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Acupuncturist",
"state": "CA",
"license": "AC9190",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Gabriel, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.