Expanse Wellness Acupuncture and Physical Therapy

Primary specialty

AcupuncturistTaxonomy code 171100000X

Legal business name

EXPANSE WELLNESS ACUPUNCTURE AND PHYSICAL THERAPY

Practice address

13906 Fiji Way Apt 352
Marina del Rey, CA 90292-6934

Phone

(818) 373-9014

NPI assigned

Feb 12, 2024

Last updated

Feb 12, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Wendy Chan, DPT, LAC, DIPL OMNPI 1285933804

Title

Owner

Phone

(818) 373-9014

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Wendy Chan, DPT, LAC, DIPL OM

  • Acupuncturist
  • Marina del Rey, CA
  • NPI 1285933804
  NPD Authorized official

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

{
    "created_epoch": "1707696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707696000000",
    "number": "1588428262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13906 FIJI WAY APT 352",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926934",
            "telephone_number": "818-373-9014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13906 FIJI WAY APT 352",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926934",
            "telephone_number": "818-373-9014"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "349 Richmond St",
            "address_purpose": "LOCATION",
            "city": "El Segundo",
            "state": "CA",
            "postal_code": "902453729",
            "country_code": "US",
            "telephone_number": "646-926-2818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EXPANSE WELLNESS ACUPUNCTURE AND PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-12",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-373-9014",
        "authorized_official_credential": "DPT, LAC, DIPL OM"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Acupuncturist in Marina del Rey, CA
• Providers in Marina del Rey, CA by specialty
• Acupuncturist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; 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.