Edward Shang Jen Wang, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

A045359 Issued in CA

Practice address

1165 Montgomery Dr
Santa Rosa, CA 95405-4801

Phone

(707) 525-5207

Fax

(707) 522-1524

NPI assigned

May 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Norcal Healthconnect LLC

  • Multi-Specialty Clinic/Center
  • Healdsburg, CA
  • NPI 1720695547
  Medicare reassignment NPD
• Norcal Healthconnect LLC

  • Critical Access Hospital
  • Healdsburg, CA
  • NPI 1861009672
  Medicare reassignment NPD
• Sonoma Valley Emergency Physicians Medical Group, Inc

  • Emergency Medicine Physician
  • Sonoma, CA
  • NPI 1710164629
  Medicare reassignment NPD
• Norcal Healthconnect LLC

  • General Acute Care Hospital
  • Petaluma, CA
  • NPI 1235162645
  NPD
• Chase Dennis Emergency Medical Group Inc

  • Emergency Medicine Physician
  • Santa Rosa, CA
  • NPI 1033152350
  NPD (past)
• Southern Solano Emergency Medical Group, Inc

  • Emergency Medicine Physician
  • Vallejo, CA
  • NPI 1629006655
  NPD (past)

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221609600000",
    "number": "1689626277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CRYSTAL CREEK DR",
            "city": "LARKSPUR",
            "state": "CA",
            "postal_code": "949391491",
            "telephone_number": "415-924-5125",
            "fax_number": "415-924-5126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1165 MONTGOMERY DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054801",
            "telephone_number": "707-525-5207",
            "fax_number": "707-522-1524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "EDWARD",
        "middle_name": "SHANG JEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2008-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A045359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Walton
• Sarah Jane Waltrip
• Beth Anne Wanamaker
• Joseph Stephen Wand, M.D.
• Carmen Wandel, PPSC
• Rita Y. F. Wang, MD
• Winnie Wei Ting Wang, FNP
• Kimiti Wangoo
• Warby Parker Inc.
• Angela Ward

• Emergency Medicine Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.