Individual provider Active NPI

William Wang, OMD PHD LAC

  • Acupuncturist
  • San Jose, CA
National Provider Identifier
1609935345
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC6414 Issued in CA
Practice address
1173 C S Deanza Blvd
San Jose, CA 95129
Phone
(408) 252-8017
Fax
(408) 252-2998
NPI assigned
Dec 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC6414 CA Primary

Addresses

Primary practice location

1173 C S Deanza Blvd
San Jose, CA 95129

Mailing address

1173 C S Deanza Blvd
San Jose, CA 95129
Phone (408) 252-8017

Other names 1

  • Xiao Hong Wang Former name

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
AC6414CAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609935345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1173 C S DEANZA BLVD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95129",
            "telephone_number": "408-252-8017",
            "fax_number": "408-252-2998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1173 C S DEANZA BLVD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95129",
            "telephone_number": "408-252-8017",
            "fax_number": "408-252-2998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "OMD PHD LAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC6414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "XIAO",
            "last_name": "WANG",
            "middle_name": "HONG",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

  • 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.