Individual provider Active NPI

Gong Wen Shi, MASSAGE THERAPIST

  • Reflexologist
  • Dublin, CA
National Provider Identifier
1679804850
Registry record updated Jan 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ReflexologistTaxonomy code 173C00000X
License
SC 21939867 Issued in CA
Practice address
7151 Amador Plaza Rd
Dublin, CA 94568-2317
Phone
(925) 833-9555
Fax
(415) 762-1960
NPI assigned
Jan 27, 2010
Last updated
Jan 27, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Reflexologist 173C00000X SC 21939867 CA Primary

Addresses

Primary practice location

7151 Amador Plaza Rd
Dublin, CA 94568-2317

Mailing address

2892 23Rd St
San Francisco, CA 94110-3444
Phone (415) 867-7775

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

LicenseStateTypeSpecialty
SC 21939867CAMDReflexologist

Practice roles

OrganizationSpecialtyStatusNew patients
Natural Health Care Center Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1264550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264550400000",
    "number": "1679804850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2892 23RD ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941103444",
            "telephone_number": "415-867-7775",
            "fax_number": "415-762-1960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7151 AMADOR PLAZA RD",
            "city": "DUBLIN",
            "state": "CA",
            "postal_code": "945682317",
            "telephone_number": "925-833-9555",
            "fax_number": "415-762-1960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHI",
        "first_name": "GONG WEN",
        "name_prefix": "Mr.",
        "credential": "MASSAGE THERAPIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-27",
        "last_updated": "2010-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173C00000X",
            "taxonomy_group": "",
            "desc": "Reflexologist",
            "state": "CA",
            "license": "SC 21939867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2010; 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.