Organization Active NPI

Wellness & Care Medical, Inc.

  • Geriatric Medicine (Family Medicine) Physician
  • City of Industry, CA
National Provider Identifier
1619164753
Registry record updated Dec 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
A98547 Issued in CA
Legal business name
WELLNESS & CARE MEDICAL, INC.
Practice address
1661 Hanover Rd
#201
City of Industry, CA 91748-1733
Phone
(626) 965-4628
Fax
(626) 965-4625
NPI assigned
Oct 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2008

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

Authorized official

Name
Dr. Yi Wang, M.D.NPI 1427248319
Title
Ceo
Phone
(626) 965-4628

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QG0300X A98547 CA Primary

Addresses

Primary practice location

1661 Hanover Rd
#201
City of Industry, CA 91748-1733

Mailing address

1661 Hanover Rd
#201
City of Industry, CA 91748-1733
Phone (626) 965-4628

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090415000680 CA Part B Supplier - Clinic/Group Practice 5799832408 Receives reassigned benefits from 2 practitioners
Practice locations: City of Industry, CA

National Provider Directory

National Provider Directory

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1191369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228521600000",
    "number": "1619164753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1661 HANOVER RD",
            "address_2": "#201",
            "city": "CITY OF INDUSTRY",
            "state": "CA",
            "postal_code": "917481733",
            "telephone_number": "626-965-4628",
            "fax_number": "626-965-4625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1661 HANOVER RD",
            "address_2": "#201",
            "city": "CITY OF INDUSTRY",
            "state": "CA",
            "postal_code": "917481733",
            "telephone_number": "626-965-4628",
            "fax_number": "626-965-4625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS & CARE MEDICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-03",
        "last_updated": "2008-12-06",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "YI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "626-965-4628",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "A98547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in City of Industry, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.