Sam Wan, ACUPUNCTURIST

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC218 Issued in CA

Practice address

408 Sunrise Ave
Suite 3
Roseville, CA 95661-4123

Phone

(916) 783-3003

Fax

(916) 783-4799

NPI assigned

Jan 30, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497891709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 SUNRISE AVE",
            "address_2": "SUITE 3",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614123",
            "telephone_number": "916-783-3003",
            "fax_number": "916-783-4799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 SUNRISE AVE",
            "address_2": "SUITE 3",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614123",
            "telephone_number": "916-783-3003",
            "fax_number": "916-783-4799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAN",
        "first_name": "SAM",
        "name_prefix": "Dr.",
        "credential": "ACUPUNCTURIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ina Marie Walts, PA-C
• Ella Walzer
• Rhonda Leah Wampler, MFT
• Richard Kurtis Wampler
• David Bennett Wampold, MD
• Jonathan Wang, DDS
• Bret Paul Wangan, LCSW
• Warby Parker Inc.
• David Andrew Ward, PA-C
• Keith Edwin Ward, D.C.

• Acupuncturist in Roseville, CA
• Providers in Roseville, CA by specialty
• Acupuncturist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.