Active NPI
Wen-Chun Jimmy Lan, MD, MS
- Neonatal-Perinatal Medicine Physician
- Santa Maria, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal-Perinatal Medicine Physician
- License
- A92292
- Practice address
- 235 S Palisade Dr
Santa Maria, CA 93454 - Phone
- (805) 739-3961
- NPI assigned
- Nov 13, 2006
- Last updated
- Nov 2, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal-Perinatal Medicine Physician | 2080N0001X | A92292 | CA | Primary |
| Pediatrics Physician | 208000000X | A92292 | CA |
Addresses
Primary practice location
235 S Palisade Dr
Santa Maria, CA 93454
Mailing address
235 S Palisade Dr
Santa Maria, CA 93454-5948
Phone (805) 739-3561
Other practice location 1
9300 Valley Childrens Pl # Sc05
Madera, CA 93636-8761
Phone (559) 353-8769
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A922920 | Medicaid | CA |
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: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine, Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A92292 | CA | MD | Neonatal-Perinatal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Valley Children's Medical Group | Pediatrics | Current | Accepting new patients |
| Valley Children's Specialty Medical Group, Inc. | Pediatrics | Past | Accepting new patients |
| LPCH Medical Group Div of Lucile | Pediatrics | Past | Accepting new patients |
| County of Santa Clara | Pediatrics | Past | Accepting new patients |
| Pacific Central Coast Health Centers | Past | Accepting new patients |
Locations
9300 Valley Childrens Pl
Madera, CA 93636
Phone (559) 353-5700
9300 Valley Childrens Pl
#5
Madera, CA 93636
Phone (559) 353-5700
1524 McHenry Ave
Ste 550570
Modesto, CA 95350
Phone (209) 572-3880
1400 E Church St
Bldg 8
Santa Maria, CA 93454
Phone (800) 739-3561
1400 E Church St
Ofc
Santa Maria, CA 93454
Phone (805) 739-3112
Interoperability endpoints
- jlan15820@valleychildrens-prd.direct-ci.com
Organizations & group practices 5
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.
-
- Pediatrics Physician
- Modesto, CA
- NPI 1437555265
-
dba SCVMC Physician Services
- Anesthesiology Physician
- San Jose, CA
- NPI 1588721500
Pediatrics
-
dba Lucile Salter Packard Children's Hospital at Stanford
- Children's Hospital
- Palo Alto, CA
- NPI 1417907940
Pediatrics
-
dba Dignity Health Women's Center - Southwest
- Community Health Clinic/Center
- Bakersfield, CA
- NPI 1720752355
-
- Pediatrics Physician
- Madera, CA
- NPI 1013968296
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698883200000",
"number": "1750452447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "235 S PALISADE DR",
"city": "SANTA MARIA",
"state": "CA",
"postal_code": "934545948",
"telephone_number": "805-739-3561",
"fax_number": "805-739-3560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "235 S PALISADE DR",
"city": "SANTA MARIA",
"state": "CA",
"postal_code": "93454",
"telephone_number": "805-739-3961"
}
],
"practiceLocations": [
{
"address_1": "9300 Valley Childrens Pl # Sc05",
"address_purpose": "LOCATION",
"city": "Madera",
"state": "CA",
"postal_code": "936368761",
"country_code": "US",
"telephone_number": "559-353-8769",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LAN",
"first_name": "WEN-CHUN",
"middle_name": "JIMMY",
"credential": "MD, MS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-13",
"last_updated": "2023-11-02",
"certification_date": "2023-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "CA",
"license": "A92292",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A92292",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A922920",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Santa Maria, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; 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.