Organization Active NPI

Ultimate Male

  • General Practice Physician
  • San Gabriel, CA
National Provider Identifier
1720878382
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
ULTIMATE MALE
Practice address
360 E Las Tunas Dr Ste 204
San Gabriel, CA 91776-5514
Phone
(626) 319-5261
NPI assigned
May 7, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2025

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

Authorized official

Name
Yuan Wang
Title
Manager
Phone
(626) 319-5261

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary
Rehabilitation Clinic/Center 261QR0400X

Addresses

Primary practice location

360 E Las Tunas Dr Ste 204
San Gabriel, CA 91776-5514

Mailing address

360 E Las Tunas Dr Ste 204
San Gabriel, CA 91776-5514

Other practice location 1

8969 W Sunset Blvd Ste B
West Hollywood, CA 90069-1834
Phone (626) 319-5261

National Provider Directory

National Provider Directory

Locations

8969 W Sunset Blvd
#B
West Hollywood, CA 90069
Phone (626) 319-5261

Practitioners & affiliated clinicians

Practitioners 1

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": "1746576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746662400000",
    "number": "1720878382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 E LAS TUNAS DR STE 204",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917765514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 E LAS TUNAS DR STE 204",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917765514",
            "telephone_number": "626-319-5261"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8969 W Sunset Blvd Ste B",
            "address_purpose": "LOCATION",
            "city": "West Hollywood",
            "state": "CA",
            "postal_code": "900691834",
            "country_code": "US",
            "telephone_number": "626-319-5261",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ULTIMATE MALE",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-07",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "YUAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "626-319-5261"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Gabriel, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2025; 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.