Active NPI
Tai-Nan Wang, L.AC., O.M.D., Q.M.E
- Acupuncturist
- San Diego, CA
National Provider Identifier
1679647366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC 537
- Practice address
- 4295 Gesner St
Ste 1a
San Diego, CA 92117-6647 - Phone
- (858) 483-7795
- Fax
- (619) 276-7937
- NPI assigned
- Nov 17, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | AC 537 | CA | Primary |
Addresses
Primary practice location
4295 Gesner St
Ste 1a
San Diego, CA 92117-6647
Mailing address
4295 Gesner St
Ste 1a
San Diego, CA 92117-6647
Phone (858) 483-7795
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 33-0062275 | Other | CA | TAX ID |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AC 537 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1679647366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4295 GESNER ST",
"address_2": "STE 1A",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921176647",
"telephone_number": "858-483-7795",
"fax_number": "619-276-7937"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4295 GESNER ST",
"address_2": "STE 1A",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921176647",
"telephone_number": "858-483-7795",
"fax_number": "619-276-7937"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANG",
"first_name": "TAI-NAN",
"name_prefix": "Mr.",
"credential": "L.AC., O.M.D., Q.M.E",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "AC 537",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "33-0062275",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Diego, 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.