Individual provider Active NPI

Craig Shaun Wang, D.O.

  • General Practice Physician
  • South El Monte, CA
National Provider Identifier
1649624867
Registry record updated Aug 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
20A23714 Issued in CA
Practice address
10414 Vacco St
South El Monte, CA 91733-3350
Phone
(626) 281-3383
Fax
(855) 710-5853
NPI assigned
Apr 14, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 20A23714 CA Primary

Addresses

Primary practice location

10414 Vacco St
South El Monte, CA 91733-3350

Mailing address

10414 Vacco St
South El Monte, CA 91733-3350
Phone (626) 281-3383

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260108002150 CA Practitioner - General Practice 9133413305 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Lake Erie College of Osteopathic Medicine, Erie, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Buddhist Tzu CHI Medical FoundationGroup PAC ID 0941551261, 4 clinicians

Practice addresses (Care Compare)

10414 Vacco St
S El Monte, CA 91733-3350
Phone (626) 281-3383

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A23714CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Buddhist Tzu CHI Medical Foundation CurrentSince Mar 24, 2025 Accepting new patients
Buddhist Tzu CHI Medical Foundation CurrentSince Oct 18, 2025 Accepting new patients

Locations

1000 S Garfield Ave
Alhambra, CA 91801
Phone (626) 281-3383

9620 Flair Dr
El Monte, CA 91731

10414 Vacco St
South El Monte, CA 91733
Phone (626) 281-3383

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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": "1460592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1649624867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10414 VACCO ST",
            "city": "SOUTH EL MONTE",
            "state": "CA",
            "postal_code": "917333350",
            "telephone_number": "626-281-3383",
            "fax_number": "855-710-5853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10414 VACCO ST",
            "city": "SOUTH EL MONTE",
            "state": "CA",
            "postal_code": "917333350",
            "telephone_number": "626-281-3383",
            "fax_number": "855-710-5853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "CRAIG",
        "middle_name": "SHAUN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-14",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "20A23714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South El Monte, CA

Sources for this page

Verify at the official NPI Registry.