Jonathan Mark Wada, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A121522 Issued in CA

Practice address

440 N Barranca Ave Ste 7665
Covina, CA 91723-1722

Phone

(323) 203-0070

Fax

(310) 561-1902

NPI assigned

Jul 1, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Concertocare Medical Group of California, P.C.

  • Internal Medicine Physician
  • Huntington Beach, CA
  • NPI 1922777259

  Family Medicine

  Medicare reassignment NPD
• Medzed Physician Services, Inc.

  • Internal Medicine Physician
  • Fresno, CA
  • NPI 1366807760
  Medicare reassignment NPD
• Hurtt Family Health Clinic Inc.

  • Federally Qualified Health Center (FQHC)
  • Anaheim, CA
  • NPI 1144760943
  NPD
• Hurtt Family Health Clinic Inc.

  • Federally Qualified Health Center (FQHC)
  • Tustin, CA
  • NPI 1306965587
  NPD

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

{
    "created_epoch": "1277942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744329600000",
    "number": "1780995068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 N BARRANCA AVE STE 7665",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917231722",
            "telephone_number": "323-203-0070",
            "fax_number": "310-561-1902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 N BARRANCA AVE STE 7665",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917231722",
            "telephone_number": "323-203-0070",
            "fax_number": "310-561-1902"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14642 Newport Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Tustin",
            "state": "CA",
            "postal_code": "927806058",
            "country_code": "US",
            "telephone_number": "714-247-0300",
            "fax_number": "714-259-1598",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Hope Dr",
            "address_purpose": "LOCATION",
            "city": "Tustin",
            "state": "CA",
            "postal_code": "927820221",
            "country_code": "US",
            "telephone_number": "714-247-0300",
            "fax_number": "714-259-1598",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "455 E Columbia St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908061620",
            "country_code": "US",
            "telephone_number": "844-822-4646",
            "fax_number": "562-933-0453",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "947 S Anaheim Blvd Ste 260",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "928055591",
            "country_code": "US",
            "telephone_number": "714-247-0300",
            "fax_number": "714-259-1598",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100B N Tustin Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Santa Ana",
            "state": "CA",
            "postal_code": "927053505",
            "country_code": "US",
            "telephone_number": "714-247-0300",
            "fax_number": "714-259-1598",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WADA",
        "first_name": "JONATHAN",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-01",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2010018037",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A121522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alen Voskanian, M.D.
• Maryam Vosogh
• Hai Mi Vu
• Deepti Vyas
• Richard Vyizigiro
• Dennis Edward Waddell, M.A.
• Taya Rae Waddell
• Allyson Ann Wagner
• Crystal Wagner
• Hibba Tul Waheed

• Family Medicine Physician in Covina, CA
• Providers in Covina, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2025; 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.