Individual provider Active NPI

Michael Charles Watung, DNP, FNP-BC

  • Family Nurse Practitioner
  • Oakland, CA
National Provider Identifier
1780221796
Registry record updated Nov 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95013395 Issued in CA
Practice address
2950 International Blvd
Oakland, CA 94601-2228
Phone
(510) 535-4400
NPI assigned
Dec 9, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95013395 CA Primary

Addresses

Primary practice location

2950 International Blvd
Oakland, CA 94601-2228

Mailing address

742 W Highland Ave
San Bernardino, CA 92405-3839
Phone (909) 881-7320

Other practice location 1

11234 Anderson St
Loma Linda, CA 92354-2804
Phone (909) 555-4000

Other practice location 2

742 W Highland Ave
San Bernardino, CA 92405-3839
Phone (909) 881-7320

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210812001747 CA Practitioner - Nurse Practitioner 6204230253 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95013395CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
City & County of San Francisco CurrentSince Jul 28, 2025 Accepting new patients
City & County of San Francisco Current Accepting new patients
Native American Health Center, Inc CurrentSince Nov 29, 2021 Accepting new patients
City and County of San Francisco CurrentSince Jul 28, 2025 Accepting new patients
Native American Health Center, Inc Current Accepting new patients
Native American Health Center, Inc CurrentSince Nov 29, 2021 Accepting new patients
California Pacific Medical Group, Inc. Past Accepting new patients

Locations

3124 International Blvd
#2D
Oakland, CA 94601

2950 International Blvd
Oakland, CA 94601
Phone (510) 485-5948

160 Capp St
San Francisco, CA 94110
Phone (415) 417-3500

1001 Potrero Ave
San Francisco, CA 94110
Phone (415) 206-2305

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: michael.watung.p1@direct.metro.nextgenshare.com

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1575849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637280000000",
    "number": "1780221796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "742 W HIGHLAND AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924053839",
            "telephone_number": "909-881-7320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 INTERNATIONAL BLVD",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946012228",
            "telephone_number": "510-535-4400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11234 Anderson St",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "923542804",
            "country_code": "US",
            "telephone_number": "909-555-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "742 W Highland Ave",
            "address_purpose": "LOCATION",
            "city": "San Bernardino",
            "state": "CA",
            "postal_code": "924053839",
            "country_code": "US",
            "telephone_number": "909-881-7320",
            "fax_number": "909-881-7330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATUNG",
        "first_name": "MICHAEL",
        "middle_name": "CHARLES",
        "credential": "DNP, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-12-09",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95013395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.